Provider Demographics
NPI:1659373140
Name:HUNTER, ROBERT EARLE III (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:EARLE
Last Name:HUNTER
Suffix:III
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 1:11320 ALTURA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-7575
Mailing Address - Country:US
Mailing Address - Phone:702-798-0744
Mailing Address - Fax:
Practice Address - Street 1:330 SOUTH CASINO CENTER
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101
Practice Address - Country:US
Practice Address - Phone:702-671-5698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10919207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H70661Medicare UPIN
NV39604Medicare ID - Type UnspecifiedNORIDIAN