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NPI Code Detail

MEDICARE: JOHN LEPORE DO PC

MEDICARE: JOHN LEPORE DO PC
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
1363LP0200XPediatric Nurse Practitioner
2208000000XPediatrics Physician

General Provider Information

NPI Number : 1205866381
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHN LEPORE DO PC
Provider Business Mailing Address
First Line : 10105 BANBURRY CROSS DR
Second Line : SUITE 170
City : LAS VEGAS
State : NV
Zip : 89144-6646
Country : US
Telephone Number : 702-765-5437
Fax Number : 702-240-7268
Provider Business Practice Location Address
First Line : 10105 BANBURRY CROSS DR
Second Line : SUITE 170
City : LAS VEGAS
State : NV
Zip : 89144-6646
Country : US
Telephone Number : 702-765-5437
Fax Number : 702-240-7268
Authorized Official
Title or Position : PRESIDENT
Name : JOHN LEPORE
Credential : DO
Telephone Number : 702-765-5437
Provider Enumeration Date : 07/04/2006
Last Update Date : 09/12/2024

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