W. WALLACE WEBSTER MD LLC NPI 1407470214

NPI Information

  • NPI: 1407470214
  • Provider Name: W. WALLACE WEBSTER MD LLC
  • Classification: Otolaryngology - 207YS0123X
  • Specialization: Facial Plastic Surgery
  • Entity Type: Organization
  • Address: 620 COMMERCIAL AVE STE A
    COOS BAY, OR
    ZIP 97420
  • Phone: (541) 297-5342

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NPI Details

W. WALLACE WEBSTER MD LLC is a facial plastic surgery otolaryngology in Coos Bay, OR. The provider is an otolaryngologist who specializes in facial plastic surgery. W. WALLACE WEBSTER MD LLC NPI is 1407470214. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

620 COMMERCIAL AVE STE A
COOS BAY, OR
ZIP 97420-846
Phone: (541) 297-5342
Fax: (541) 808-0415

The provider's authorized official is William Wallace Webster .
The authorized official title is Owner and has the following contact phone number (541) 297-5342.

The enumeration date for this NPI number is 6/8/2020 and was last updated on 6/8/2020.

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
1207YS0123XOtolaryngologyFacial Plastic SurgeryYes

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
1274244MEDICAIDOREGON

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: 11/21/2025

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