Provider Demographics
NPI:1184644056
Name:NOBLE, LARRY M (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:M
Last Name:NOBLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30084
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89520-3084
Mailing Address - Country:US
Mailing Address - Phone:775-333-7440
Mailing Address - Fax:775-327-8199
Practice Address - Street 1:1500 E 2ND ST
Practice Address - Street 2:SUITE 400
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1262
Practice Address - Country:US
Practice Address - Phone:775-982-2400
Practice Address - Fax:775-982-2888
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4087207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002016704Medicaid
NVCC2335OtherBLUE CROSS BLUE SHIELD
CAXPY183360Medicaid
NV002016704Medicaid
NVCC2335OtherBLUE CROSS BLUE SHIELD
NV060020711Medicare PIN