Healthcare Provider Details

I. General information

NPI: 1205869435
Provider Name (Legal Business Name): THOMAS J HESS MD A PROF CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 03/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1641 E FLAMINGO RD STE 10
LAS VEGAS NV
89119-5257
US

IV. Provider business mailing address

1641 E FLAMINGO RD STE 10
LAS VEGAS NV
89119-5257
US

V. Phone/Fax

Practice location:
  • Phone: 702-734-4377
  • Fax: 702-369-8057
Mailing address:
  • Phone: 702-734-4377
  • Fax: 702-369-8057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number10560
License Number StateNV

VIII. Authorized Official

Name: THOMAS JOSEPH HESS
Title or Position: OWNER
Credential: MD
Phone: 702-734-4377