Provider Demographics
NPI:1649364530
Name:HUEY, DOYLE WADE (MD)
Entity type:Individual
Prefix:DR
First Name:DOYLE
Middle Name:WADE
Last Name:HUEY
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 1:6355 S BUFFALO DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2133
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:2550 NATURE PARK DR STE 235
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-3205
Practice Address - Country:US
Practice Address - Phone:702-948-1150
Practice Address - Fax:702-688-8862
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5190207Q00000X
NV17607207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV17607OtherSTATE LICENSE
NV1649364530Medicaid
ORR189837Medicare PIN
TXC17168Medicare UPIN
TX00831780OtherUHC
TX80173181OtherRAILROAD MEDICARE
TX563526OtherHUMANA HMO
TX23298OtherFIRST HEALTH
TX8260N1Medicare PIN