Healthcare Provider Details
I. General information
NPI: 1114221330
Provider Name (Legal Business Name): TED CURTIS HANF D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/03/2011
Last Update Date: 07/07/2023
Certification Date: 07/07/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1501 W SUNSET RD
HENDERSON NV
89014-6636
US
IV. Provider business mailing address
102 WOODMONT BLVD STE 600
NASHVILLE TN
37205-5250
US
V. Phone/Fax
- Phone: 725-269-7001
- Fax: 725-269-7003
- Phone: 615-315-5257
- Fax: 615-692-0547
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 570 |
| License Number State | NV |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | N5096 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: