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CENTRAL OREGON DERMATOLOGY PC NPI 1336307875


NPI Information

NPI: 1336307875
Provider Name: CENTRAL OREGON DERMATOLOGY, PC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
388 SW BLUFF DR
BEND, OR
ZIP 97702
Phone: (541) 678-0020
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CENTRAL OREGON DERMATOLOGY, PC is a clinic center in Bend, OR. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). CENTRAL OREGON DERMATOLOGY, PC NPI is 1336307875. The provider is registered as an organization entity type.

The provider's business location address is:

388 SW BLUFF DR
BEND, OR
ZIP 97702-360
Phone: (541) 678-0020
Fax: (541) 383-2174

The provider's authorized official is Jodi Haney .
The authorized official title is Office Manager and has the following contact phone number (541) 323-2181.

The enumeration date for this NPI number is 5/31/2008 and was last updated on 3/7/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterMD26648OREGONYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1MD26648OTHEROREGONLICENSE
2241835MEDICAIDOREGON
31609815166OTHEROREGONNPI (INDIVIDUAL)

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.