Provider Demographics
NPI:1912096157
Name:CADE, JOHN EARL (DPM)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:EARL
Last Name:CADE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3320 NORTH BUFFALO DRIVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7410
Mailing Address - Country:US
Mailing Address - Phone:702-256-8454
Mailing Address - Fax:702-256-0387
Practice Address - Street 1:3320 NORTH BUFFALO DRIVE
Practice Address - Street 2:SUITE 107
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7410
Practice Address - Country:US
Practice Address - Phone:702-256-8454
Practice Address - Fax:702-256-0387
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV9701213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV35851Medicare ID - Type Unspecified
NVT01973Medicare UPIN