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JOHN R GLYER D MILLS MATHESON & MARGARET ARNER MDS PTR NPI 1568525400


NPI Information

NPI: 1568525400
Provider Name: JOHN R GLYER D MILLS MATHESON & MARGARET ARNER MDS PTR

Doing Business As: BAECHTEL CREEK MEDICAL CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 05D0612624

Address:
1245 S MAIN ST
WILLITS, CA
ZIP 95490
Phone: (707) 459-6861
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JOHN R GLYER D MILLS MATHESON & MARGARET ARNER MDS PTR is a rural health clinic center in Willits, CA. JOHN R GLYER D MILLS MATHESON & MARGARET ARNER MDS PTR NPI is 1568525400. The provider is registered as an organization entity type.
The provider Is Doing Business As Baechtel Creek Medical Clinic.

The provider's business location address is:

1245 S MAIN ST
WILLITS, CA
ZIP 95490-305
Phone: (707) 459-6861
Fax: (707) 459-3057

The provider's authorized official is Donald Mills Matheson .
The authorized official title is Managing Partner and has the following contact phone number (707) 459-6861.

The CLIA number assigned to this NPI record is 05D0612624 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/19/2006 and was last updated on 12/15/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR1300XClinic/CenterRural Health053968CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1ZZZ78182ZMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAMEDICARE PROVIDER #
2053968MEDICARE OSCAR/CERTIFICATIONCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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