Provider Demographics
NPI:1386684272
Name:LAGIOS, JOHN P (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:LAGIOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 MOUNTAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-3819
Mailing Address - Country:US
Mailing Address - Phone:775-885-9400
Mailing Address - Fax:775-885-8768
Practice Address - Street 1:915 MOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-3819
Practice Address - Country:US
Practice Address - Phone:775-885-9400
Practice Address - Fax:775-885-8768
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV96562084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2013071Medicaid
B38558Medicare UPIN
V34433Medicare ID - Type Unspecified