Individual
JOHN WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4475 S EASTERN AVE, SUITE 222, LAS VEGAS, NV 89119-7826
(702) 767-1800
(702) 737-5988
Mailing address
PO BOX 15645, CREDENTIALING DEPARTMENT, LAS VEGAS, NV 89114-5645
(702) 737-1800
(702) 737-5988
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
005544
NY
363A00000X
Physician Assistant
6961599-1206
UT
363A00000X
Physician Assistant
Primary
PA1445
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942243092
—
NV
01
—
P01257617
RAILROAD MEDICARE
NV
Enumeration date
06/14/2006
Last updated
03/25/2014
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