Provider Demographics
NPI:1902050388
Name:HILMES, ERIC D (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:D
Last Name:HILMES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1569
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89125-1569
Mailing Address - Country:US
Mailing Address - Phone:702-671-6846
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:3100 N TENAYA WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0436
Practice Address - Country:US
Practice Address - Phone:702-255-5025
Practice Address - Fax:702-671-6883
Is Sole Proprietor?:No
Enumeration Date:2008-11-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1139363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVPR01242OtherPHARMACY CERTIFICATE
NVPA1139OtherPA-C LICENSE
NVMH1897656OtherDEA
NVMH1897656OtherDEA