MEDICARE: ROBERT EARLE HUNTER III MD

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	207Q00000X	Family Medicine Physician	10919	NV

General Provider Information

NPI Number	:	1659373140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT EARLE HUNTER III MD

Provider Business Mailing Address
First Line	:	11320 ALTURA VISTA DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89138-7575
Country	:	US
Telephone Number	:	702-798-0744
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 SOUTH CASINO CENTER
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101
Country	:	US
Telephone Number	:	702-671-5698
Fax Number	:

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

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	07/08/2007

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