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Individual

MR. ERIC HARALSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
270 W LAKE MEAD PKWY, HENDERSON, NV 89015-7093
(702) 677-3720
(702) 677-3733
Mailing address
6803 W TROPICANA AVE, STE 100, LAS VEGAS, NV 89103-4927
(702) 452-2526
(702) 452-2525

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA0321
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1871961797
NV
01
P01700941
RAILROAD MEDICARE
NV
Enumeration date
09/09/2015
Last updated
09/05/2017
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