Provider Demographics
NPI:1053468702
Name:LINDA LAFFERTY, D.O., LTD.
Entity Type:Organization
Organization Name:LINDA LAFFERTY, D.O., LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFFERTY
Authorized Official - Suffix:
Authorized Official - Credentials:D O
Authorized Official - Phone:775-828-5100
Mailing Address - Street 1:6580 S MCCARRAN BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6112
Mailing Address - Country:US
Mailing Address - Phone:775-828-5100
Mailing Address - Fax:
Practice Address - Street 1:6580 S MCCARRAN BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6112
Practice Address - Country:US
Practice Address - Phone:775-828-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV0366305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service