Provider Demographics
NPI:1366604290
Name:KOKMEYER, DANIEL T (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:T
Last Name:KOKMEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9321 W. SUNSET RD.
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148
Mailing Address - Country:US
Mailing Address - Phone:775-645-7800
Mailing Address - Fax:
Practice Address - Street 1:9321 W. SUNSET RD.
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148
Practice Address - Country:US
Practice Address - Phone:702-645-7800
Practice Address - Fax:702-650-0865
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15443207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
12512868OtherCAQH
NVP01419836OtherRR MEDICARE
NVV108252Medicare PIN