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General NPI Number Information
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NPI Number | 1740854439
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Entity Type | Individual
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Provider Name | JOHN PATRICK WALSH DO
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Gender | Male
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Dates
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Enumeration Date | 05/17/2021
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Last Update Date | 05/17/2021
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Provider Practice Location Address
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Address Line | 700 SHADOW LN STE 400
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City | LAS VEGAS
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State | NV
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Zip | 89106-4159
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Country | US
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Telephone | 702-388-4512
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Fax |
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Provider Business Mailing Address
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Address Line | 700 SHADOW LN STE 400
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City | LAS VEGAS
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State | NV
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Zip | 89106-4159
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | SL1719
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License Number State | NV
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