Provider Demographics
NPI:1154893618
Name:AKOH, FERDINAND A
Entity type:Individual
Prefix:
First Name:FERDINAND
Middle Name:A
Last Name:AKOH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 E CHARLESTON BLVD
Mailing Address - Street 2:MEDICAL STAFF
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102
Mailing Address - Country:US
Mailing Address - Phone:702-383-2000
Mailing Address - Fax:702-248-0728
Practice Address - Street 1:61 N NELLIS BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110
Practice Address - Country:US
Practice Address - Phone:702-383-6240
Practice Address - Fax:702-459-8586
Is Sole Proprietor?:No
Enumeration Date:2018-12-21
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139981363LF0000X
NV817125363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily