Individual
BRANT BARRY HAFEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2704 N TENAYA WAY, LAS VEGAS, NV 89128-0424
(702) 877-5199
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 877-5199
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO3209
NV
390200000X
Student in an Organized Health Care Education/Training Program
TL000----
CO
Other
Enumeration date
03/21/2019
Last updated
09/28/2022
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