MEDICARE: ELIZABETH L HUCK DO

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
1	2085R0202X	Diagnostic Radiology Physician	DO2004	NV

General Provider Information

NPI Number	:	1255375838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH L HUCK DO

Provider Business Mailing Address
First Line	:	7241 W SAHARA AVE
Second Line	:	SUITE 120
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2858
Country	:	US
Telephone Number	:	702-254-5004
Fax Number	:	702-432-4005

Provider Business Practice Location Address
First Line	:	8530 W SUNSET RD
Second Line	:	SUITE 120
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2215
Country	:	US
Telephone Number	:	702-254-5004
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	09/03/2015

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