Provider Demographics
NPI:1053378836
Name:SELZNICK, HUGH S (MD)
Entity type:Individual
Prefix:
First Name:HUGH
Middle Name:S
Last Name:SELZNICK
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:PO BOX 30667
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89173
Mailing Address - Country:US
Mailing Address - Phone:702-777-2663
Mailing Address - Fax:702-777-0030
Practice Address - Street 1:3006 S MARYLAND PKWY
Practice Address - Street 2:570
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2218
Practice Address - Country:US
Practice Address - Phone:702-777-2663
Practice Address - Fax:702-777-0030
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9199207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVF32796Medicare UPIN
NVV101077Medicare PIN
NVV101076Medicare PIN