Healthcare Provider Details

I. General information

NPI: 1124575170
Provider Name (Legal Business Name): LOUGH, HAUSER AND TOMLINSON LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2016
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 RYLAND ST
RENO NV
89502-1605
US

IV. Provider business mailing address

900 RYLAND ST
RENO NV
89502-1605
US

V. Phone/Fax

Practice location:
  • Phone: 775-323-2157
  • Fax: 775-323-0749
Mailing address:
  • Phone: 775-323-2157
  • Fax: 775-323-0749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberNV20141644677
License Number StateNV

VIII. Authorized Official

Name: JEREMY DAVID LOUGH
Title or Position: PRESIDENT
Credential: MD
Phone: 775-323-2157