Healthcare Provider Details

I. General information

NPI: 1811331663
Provider Name (Legal Business Name): CORTNEY B CASPER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2013
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6970 S CIMARRON RD STE 230
LAS VEGAS NV
89113-2135
US

IV. Provider business mailing address

8906 SPANISH RIDGE AVE STE 202
LAS VEGAS NV
89148-1319
US

V. Phone/Fax

Practice location:
  • Phone: 702-871-0303
  • Fax: 702-562-0054
Mailing address:
  • Phone: 702-330-3102
  • Fax: 702-912-4994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301103276
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2154193
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberM-14718
License Number StateID
# 4
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25729
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: