GLENN M KOTEEN M.D. LLC NPI 1407021348

NPI Information

GLENN M KOTEEN M.D., LLC is a medical specialty clinic center in Bend, OR. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). GLENN M KOTEEN M.D., LLC NPI is 1407021348. The provider is registered as an organization entity type.
The provider Is Doing Business As Gastroenterology Of Central Oregon.

The provider's business location address is:

2450 NE MARY ROSE PL
STE 210
BEND, OR
ZIP 97701-132
Phone: (541) 728-0535
Fax: (541) 647-5125

The provider's authorized official is Glenn M Koteen .
The authorized official title is Owner/physician and has the following contact phone number (541) 728-0535.

The enumeration date for this NPI number is 4/22/2008 and was last updated on 11/14/2008.

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:

Other Identifiers

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

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