Healthcare Provider Details

I. General information

NPI: 1093945149
Provider Name (Legal Business Name): RICHARD HODNETT MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2009
Last Update Date: 02/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6332 S RAINBOW BLVD SUITE 120
LAS VEGAS NV
89118-3234
US

IV. Provider business mailing address

6332 S RAINBOW BLVD SUITE 120
LAS VEGAS NV
89118-3234
US

V. Phone/Fax

Practice location:
  • Phone: 702-507-9911
  • Fax: 702-891-8866
Mailing address:
  • Phone: 702-507-9911
  • Fax: 702-891-8866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD M HODNETT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 702-507-9911