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Contact Information

KELLY R GARDNER, MD
3061 S MARYLAND PKWY
SUITE 102
LAS VEGAS, NV89109-2298
 Phone: 702-731-2888
 Fax: 702-696-9289
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular & Interventional Radiology

2085R0204X 94 Physician/Interventional Radiology
Indicates primary specialty

NPI Profile & details for KELLY R GARDNER · (Male)

NPI # 1255319463
Status Active
Credentials MD
Entity Individual
Enumeration date 01/06/2006
Last updated 12/28/2012 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • NV License # 6324
  • NV Medicaid 200290213
  • NV Other NV1309 BLUE
Hospital affiliation(s)
  • HAVASU REGIONAL MEDICAL CENTER - (Acute Care)
    101 CIVIC CENTER LANE
    LAKE HAVASU CITY, AZ 86403
  • MOUNTAINVIEW HOSPITAL - (Acute Care)
    3100 N TENAYA WAY
    LAS VEGAS, NV 89128
  • SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER - (Acute Care)
    9300 WEST SUNSET RD
    LAS VEGAS, NV 89148
  • SUNRISE HOSPITAL AND MEDICAL CENTER - (Acute Care)
    3186 S MARYLAND PKWY
    LAS VEGAS, NV 89109
  • UMC OF SOUTHERN NEVADA - (Acute Care)
    1800 W CHARLESTON BLVD
    LAS VEGAS, NV 89102
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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