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Individual

JOHN J KASTRUP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1505 WIGWAM PKWY, #330, HENDERSON, NV 89074-8194
(702) 878-0393
(702) 933-0633
Mailing address
7455 W WASHINGTON AVE, STE 160, LAS VEGAS, NV 89128-4356
(702) 878-0393

Taxonomy

Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
12909
NV
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
MD041982L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
279524800
FL
01
68052
BCBS
FL
01
P00451374
RAILROAD MEDICARE
FL
Enumeration date
08/21/2006
Last updated
01/28/2016
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