Individual
ROBERT TUCKER THOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
975 RYLAND ST STE 100, RENO, NV 89502
(775) 982-5000
(775) 982-5225
Mailing address
850 HARVARD WAY, RENO, NV 89502-2055
(775) 982-4590
(775) 982-4595
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9686
NV
207QS0010X
Sports Medicine (Family Medicine) Physician
9686
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002016818
—
NV
01
—
080173706
RAILROAD MEDICARE
NV
01
—
11042017
CAQH
—
01
—
P00259419
RR MEDICARE
NV
Enumeration date
02/09/2006
Last updated
09/06/2019
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