Healthcare Provider Details

I. General information

NPI: 1497771281
Provider Name (Legal Business Name): HOPE FAMILY PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1995 ERRECART BLVD SUITE 203
ELKO NV
89801-8334
US

IV. Provider business mailing address

1995 ERRECART BLVD SUITE 203
ELKO NV
89801-8334
US

V. Phone/Fax

Practice location:
  • Phone: 775-777-2210
  • Fax: 775-777-1113
Mailing address:
  • Phone: 775-777-2210
  • Fax: 775-777-1113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number9637
License Number StateNV

VIII. Authorized Official

Name: DR. PAUL D HERMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 775-777-2210