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NPI Code Detail

MEDICARE: DR. HOLLIS M JULSON M.D.

MEDICARE: DR. HOLLIS M JULSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianDR.0049556CO
2207Q00000XFamily Medicine Physician15497NV

General Provider Information

NPI Number : 1104811470
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HOLLIS M JULSON M.D.
Provider Business Mailing Address
First Line : PO BOX 15645
Second Line :
City : LAS VEGAS
State : NV
Zip : 89114-5645
Country : US
Telephone Number : 702-877-8600
Fax Number : 702-258-6152
Provider Business Practice Location Address
First Line : 888 S RANCHO DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-3810
Country : US
Telephone Number : 702-877-8600
Fax Number : 702-258-6152
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2005
Last Update Date : 10/11/2023

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