Healthcare Provider Details

I. General information

NPI: 1912534348
Provider Name (Legal Business Name): GARRISON MEDICAL CONSULTANTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 W HORIZON RIDGE PKWY STE 130
HENDERSON NV
89052-2731
US

IV. Provider business mailing address

2440 W HORIZON RIDGE PKWY STE 130
HENDERSON NV
89052-2731
US

V. Phone/Fax

Practice location:
  • Phone: 702-881-8191
  • Fax:
Mailing address:
  • Phone: 702-881-8191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN ALLEN GARRISON
Title or Position: MANAGING MEMBER
Credential: DO
Phone: 702-881-8191