Provider Demographics
NPI:1609968395
Name:PAULY, QUINN (MD)
Entity type:Individual
Prefix:DR
First Name:QUINN
Middle Name:
Last Name:PAULY
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 7192
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89510-7192
Mailing Address - Country:US
Mailing Address - Phone:775-260-9284
Mailing Address - Fax:702-263-0609
Practice Address - Street 1:150 W HUFFAKER LN STE 103
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2098
Practice Address - Country:US
Practice Address - Phone:775-260-9284
Practice Address - Fax:702-263-0609
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9993207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
11205549OtherCAQH
NV1609968395Medicaid
11205549OtherCAQH
NVFA903YMedicare PIN
NVP01170775OtherRR MEDICARE PTAN