Provider Demographics
NPI:1053394148
Name:COHLER, LARRY F (MD)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:F
Last Name:COHLER
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:PO BOX 71236
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89170-1236
Mailing Address - Country:US
Mailing Address - Phone:702-731-0022
Mailing Address - Fax:702-731-0292
Practice Address - Street 1:3061 S MARYLAND PKWY
Practice Address - Street 2:SUITE 202
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2298
Practice Address - Country:US
Practice Address - Phone:702-731-0022
Practice Address - Fax:702-731-0292
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8990208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018109Medicaid
NVV38159Medicare ID - Type Unspecified
NV002018109Medicaid