Provider Demographics
NPI:1699841254
Name:O'LAUGHLIN, ROBERT C (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:O'LAUGHLIN
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3006 S MARYLAND PKWY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-2229
Mailing Address - Country:US
Mailing Address - Phone:702-735-7154
Mailing Address - Fax:702-735-7153
Practice Address - Street 1:8285 W ARBY AVENUE
Practice Address - Street 2:SUITE 100A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113
Practice Address - Country:US
Practice Address - Phone:702-735-7154
Practice Address - Fax:702-405-1862
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD10713174400000X
KY456742085R0001X
NV123982085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
E88323Medicare UPIN
HIE88323Medicare UPIN