Provider Demographics
NPI:1730152364
Name:HESS, JOHN (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:HESS
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 1:411 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4415
Mailing Address - Country:US
Mailing Address - Phone:775-770-7600
Mailing Address - Fax:775-770-7880
Practice Address - Street 1:6630 S MCCARRAN BLVD STE 9
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6145
Practice Address - Country:US
Practice Address - Phone:775-204-4000
Practice Address - Fax:775-204-4001
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8692207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002016487Medicaid
11426275OtherCAQH
NV80124584OtherRAILROAD MEDICARE
NV80124584OtherRAILROAD MEDICARE
G69289Medicare UPIN