Provider Demographics
NPI:1174642573
Name:JOHN E. HERR, M.D. A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:JOHN E. HERR, M.D. A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HERR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-435-3535
Mailing Address - Street 1:1701 N GREEN VALLEY PKWY STE 4C
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-5886
Mailing Address - Country:US
Mailing Address - Phone:702-435-3535
Mailing Address - Fax:702-435-1324
Practice Address - Street 1:1701 N GREEN VALLEY PKWY STE 4C
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-5886
Practice Address - Country:US
Practice Address - Phone:702-435-3535
Practice Address - Fax:702-435-1324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVC02275Medicare UPIN
NV0561390001Medicare NSC
NVVBFBQVMedicare ID - Type Unspecified