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NPI Code Detail

MEDICARE: DR. JOHN R SHEPHERD M.D.

MEDICARE: DR. JOHN R SHEPHERD M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician2310NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124079454
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN R SHEPHERD M.D.
Provider Business Mailing Address
First Line : 2921 AUGUSTA DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-1547
Country : US
Telephone Number : 702-737-7389
Fax Number :
Provider Business Practice Location Address
First Line : 3575 PECOS MCLEOD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-3803
Country : US
Telephone Number : 702-731-2088
Fax Number : 702-734-7836
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 07/09/2007

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Directions to “ DR. JOHN R SHEPHERD M.D.” Practice Location

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