Provider Demographics
NPI:1598891152
Name:DAUGHARTHY, JAMES B (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:DAUGHARTHY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1070 RANCHO CIR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-4623
Mailing Address - Country:US
Mailing Address - Phone:702-878-9696
Mailing Address - Fax:702-614-6562
Practice Address - Street 1:3150 N TENAYA WAY
Practice Address - Street 2:# 440
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0443
Practice Address - Country:US
Practice Address - Phone:702-240-2963
Practice Address - Fax:702-240-9984
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2016-06-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV3880208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002002289Medicaid
NV002002289Medicaid
NVC95941Medicare UPIN