Healthcare Provider Details

I. General information

NPI: 1043266836
Provider Name (Legal Business Name): PHILIP M HESS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 06/11/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3955 N PECOS RD
LAS VEGAS NV
89115
US

IV. Provider business mailing address

2251 N RAMPART BLVD # 248
LAS VEGAS NV
89128-7640
US

V. Phone/Fax

Practice location:
  • Phone: 702-555-1212
  • Fax:
Mailing address:
  • Phone: 702-501-9631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number9945
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: