Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 092756 | OH |
N | 207W00000X | Ophthalmologist | C52689 | CA |
N | 207W00000X | Ophthalmologist | MD2020-0577 | NM |
Y | 207W00000X | Ophthalmologist | MD204340 | OR |
NPI | 1013990027 |
---|---|
Provider Name | Dr. Kurt W Andreason |
First Address | Bend, OR 97701-6051 |
Second Address | Bend, OR 97701-6051 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2005 |
Last Update Date | 13/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500792600 | (05) | OR |