Individual
JOHN M KANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4475 S EASTERN AVE, LAS VEGAS, NV 89119-7826
(702) 669-5840
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 877-5153
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17273
NV
207Q00000X
Family Medicine Physician
35-128957
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437558111
—
NV
01
—
V52130
SMA MEDICARE
NV
Enumeration date
08/19/2014
Last updated
06/18/2024
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