MEDICARE: DR. DANIEL W. HALBY D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	250	NV
2	207Q00000X	Family Medicine Physician	20A 4091	CA

General Provider Information

NPI Number	:	1134491459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL W. HALBY D.O.

Provider Business Mailing Address
First Line	:	3104 SONIA DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-3246
Country	:	US
Telephone Number	:	702-258-6229
Fax Number	:

Provider Business Practice Location Address
First Line	:	5524 S FORT APACHE RD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-7669
Country	:	US
Telephone Number	:	702-258-6229
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2012
Last Update Date	:	02/01/2012

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