MEDICARE: DONALD E HOARD M.D.

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	174400000X	Specialist	036046409	IL
2	208800000X	Urology Physician	14613	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	21605923	OTHER	IL	BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457460529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD E HOARD M.D.

Provider Business Mailing Address
First Line	:	PO BOX 35380
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5380
Country	:	US
Telephone Number	:	702-877-0814
Fax Number	:	702-877-3238

Provider Business Practice Location Address
First Line	:	2010 GOLDRING AVE
Second Line	:	SUITE 200
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4002
Country	:	US
Telephone Number	:	702-877-0814
Fax Number	:	702-877-3238

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	06/08/2016

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