Provider Demographics
NPI:1912534348
Name:GARRISON MEDICAL CONSULTANTS PLLC
Entity Type:Organization
Organization Name:GARRISON MEDICAL CONSULTANTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-881-8191
Mailing Address - Street 1:2440 W HORIZON RIDGE PKWY STE 130
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2731
Mailing Address - Country:US
Mailing Address - Phone:702-881-8191
Mailing Address - Fax:
Practice Address - Street 1:2440 W HORIZON RIDGE PKWY STE 130
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2731
Practice Address - Country:US
Practice Address - Phone:702-881-8191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-25
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty