Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 57009671 | OH |
N | 111NI0900X | Internist | 57009671 | OH |
N | 207R00000X | Internist | A104755 | CA |
N | 111NI0900X | Internist | A104755 | CA |
Y | 207R00000X | Internist | MD28723 | OR |
Y | 111NI0900X | Internist | MD28723 | OR |
NPI | 1003010117 |
---|---|
Provider Name | Dr. John W Egar |
First Address | Eugene, OR 97402-0451 |
Second Address | Florence, OR 97439-9470 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 29/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
026065 | (05) | OR |
2836739 | (05) | OH |
91143 | OHIO LICENCE (01) | OH |
A104755 | STATE LICENSE (01) | CA |
FE0701878 | DEA (01) | |
MD28723 | STATE LICENSE (01) | OR |