DR. RUSSELL PATRICK GOLLARD (NPI# 1699772210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699772210 |
| Entity Type | Individual |
| Full Name | DR. RUSSELL PATRICK GOLLARD |
| Credential | M.D. |
| Practice Address |
3175 Saint Rose Pkwy Fl 2 Henderson NV 89052-3506 |
| Mailing Address |
Po Box 35380 Las Vegas NV 89133-5380 |
| Practice Telephone | 7027248787 |
| Practice Fax Number | 7028783078 |
| Enumeration Date | 2005-06-29 |
| Last Update Date | 2018-01-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
7818 | NV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | RAILROAD MEDICARE | 830006195 | 01 |
| NV | 002019902 | 05 | |
| AZ | 121745 | 05 |
| Street Address |
3175 SAINT ROSE PKWY FL 2 |
| City | HENDERSON |
| State | NV |
| Zip Code | 89052-3506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972892750 | Jacqueline Malekirad | Internal Medicine | 3175 Saint Rose Pkwy Fl 2, Henderson, NV 89052 | 2011-04-01 |
| 1316903768 | Eric A Gershman | Internal Medicine | 3175 Saint Rose Pkwy Fl 2, Henderson, NV 89052-3506 | 2006-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740889112 | Nathan Michael Nasternak | Physical Therapist | 750 Coronado Center Drive, Suite 140, 2212, Henderson, NV 89052 | 2020-10-18 |
| 1558987180 | Braxton Chad Storm | Counselor | 2990 W. Sundridge Heights Pkwy, Suite #140, Henderson, NV 89052 | 2020-06-19 |
| 1558996546 | The Eye Doctor At St. Rose LLC | Eyewear Supplier (Equipment, not the service) | 2645 St. Rose Parkway, Suite C-110, Henderson, NV 89052 | 2020-03-10 |
| 1770138521 | Quinn Dentists of St. Rose, PC | Dentist | 3519 St Rose Parkway, Ste 110, Henderson, NV 89052 | 2019-08-08 |
| 1346802568 | Rickie Kwong Chin Jr. | Optometrist | 695 S. Green Valley Pkwy, Henderson, NV 89052 | 2019-07-08 |
| 1134695646 | Nu Smiles, LLC | Clinic/Center | 2810 W. Horizon Ridge Parkway, Suite #110, Henderson, NV 89052 | 2018-10-23 |
| 1003393497 | Katherine Lee Villarreal | Physical Therapist | 2930 W Horizon Pkwy, Suite 205, Henderson, NV 89052 | 2018-07-27 |
| 1790281889 | Vicki Lorraine Schmidt | Nurse Practitioner | 2900 W. Horizon Ridge Pkwy, Suite 101, Henderson, NV 89052 | 2018-04-05 |
| 1326566969 | Shelby Schiller | Social Worker | 3051 W Horizon Ridge Pkwy Ste 104a, Henderson, NV 89052 | 2017-09-04 |
| 1639696826 | Pca Ventures, LLC | Technician | 2656 Soda Butte Court, Henderson, NV 89052 | 2017-08-28 |
| Find all providers in zip 89052 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396856506 | Arshad Iftekhar Husain | Internal Medicine | 110 N Water St, Henderson, KY 42420-3142 | 2006-08-31 |
| 1972512390 | Paul Michael | Internal Medicine | 199 Courtney Ann Dr, Henderson, NV 89074 | 2006-08-05 |
| 1083611362 | Edgardo Averion Faylona | Internal Medicine | 58 N Pecos Rd, Henderson, NV 89074-7319 | 2005-07-01 |
| 1295732808 | Hyo-jong Park | Internal Medicine | 2460 W Horizon Ridge Pkwy, Henderson, NV 89052-2648 | 2005-06-29 |
| 1235136854 | Gilbert Mudiwa Nyamuswa | Internal Medicine | 10001 S Eastern Ave Ste 301, Henderson, NV 89052 | 2005-06-29 |
| 1538561865 | Dlp Maria Parham Physician Practices, LLC | Internal Medicine | 120 Charles Rollins Rd, Suite 206, Henderson, NC 27536-2882 | 2014-09-18 |
| 1972892750 | Jacqueline Malekirad | Internal Medicine | 3175 Saint Rose Pkwy Fl 2, Henderson, NV 89052 | 2011-04-01 |
| 1285869727 | Stephani Dawn Christensen | Internal Medicine | 1505 Wigwam Pkwy Ste 130, Henderson, NV 89074-8195 | 2009-05-28 |
| 1295990323 | Private Diagnostic Clinic, Pllc | Internal Medicine | 566 Ruin Creek Rd, Henderson, NC 27536-2927 | 2008-07-29 |
| 1487819421 | New Hope Blood and Cancer Center | Internal Medicine | 110 N Water St, Henderson, KY 42420-3142 | 2008-07-18 |
| Find all providers in HENDERSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.