Basic Information
| Provider Information | |||||||||
| NPI: | 1497733265 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FILDES | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2040 W CHARLESTON BLVD | ||||||||
| Address2: | #301 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891022227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026712201 | ||||||||
| FaxNumber: | 7023859399 | ||||||||
| Practice Location | |||||||||
| Address1: | 1707 W CHARLESTON BLVD | ||||||||
| Address2: | SUITE 160 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891022351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026712201 | ||||||||
| FaxNumber: | 7023859399 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2006 | ||||||||
| LastUpdateDate: | 01/03/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0127X | 7717 | NV | Y | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 208600000X | 7717 | NV | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0102X | 7717 | NV | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care |
ID Information
| ID | Type | State | Issuer | Description | 880330858 | 01 | NV | ANTHEM BC/BS | OTHER | 880330858 | 01 | NV | SIERRA HEALTH SERVICES | OTHER | 880330858 | 01 | NV | GREAT-WEST | OTHER | 880330858 | 01 | NV | PACIFICARE | OTHER | 967532 | 01 | NV | FIRST HEALTH/CCN | OTHER | XPY189314 | 01 | NV | MEDI-CAL | OTHER | 629917 | 01 | NV | AHCCCS | OTHER | 880330858 | 01 | NV | AFFILIATED HEALTH FUNDS | OTHER | 880330858 | 01 | NV | CIGNA | OTHER | 880330858 | 01 | NV | UNITED HEALTHCARE | OTHER | CD9455 | 01 | NV | MEDICARE - RR | OTHER | 880330858 | 01 | NV | UNIVERSAL HEALTH NETWORK | OTHER | 880330858 | 01 | NV | HORIZON/MCC | OTHER | 000R4167 | 01 | NV | MEDICAID - MEXICO | OTHER | 002019832 | 05 | NV | MEDICAID | 537373 | 01 | NV | USA/MCO HEALTH NETWORKS | OTHER | 880330858 | 01 | NV | CHOICE CARE/HUMANA | OTHER |