Healthcare Provider Details

I. General information

NPI: 1932785474
Provider Name (Legal Business Name): JOSHUA DARRYL HARDY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9499 W CHARLESTON BLVD STE 200
LAS VEGAS NV
89117-7147
US

IV. Provider business mailing address

9499 W CHARLESTON BLVD STE 200
LAS VEGAS NV
89117-7147
US

V. Phone/Fax

Practice location:
  • Phone: 725-204-0912
  • Fax: 725-900-9282
Mailing address:
  • Phone: 725-204-0912
  • Fax: 725-900-9282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number29143
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number29143
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: