Provider Demographics
NPI:1821076092
Name:HOBART, HOLLY H (PHD)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:H
Last Name:HOBART
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:2040 W CHARLESTON BLVD
Mailing Address - Street 2:202-A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2227
Mailing Address - Country:US
Mailing Address - Phone:702-671-2355
Mailing Address - Fax:702-382-5388
Practice Address - Street 1:1707 W. CHARLESTON BLVD- DBA NEVADA GENETICS LABORATORY
Practice Address - Street 2:110-B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2351
Practice Address - Country:US
Practice Address - Phone:702-671-5055
Practice Address - Fax:702-671-0193
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV16016 DIR-0207SC0300X, 207SG0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207SC0300XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Cytogenetics
Not Answered207SG0205XAllopathic & Osteopathic PhysiciansMedical GeneticsPh.D. Medical Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV16016-DIR-0OtherSTAT LICENSE