Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD07035 | OR |
NPI | 1013286822 |
---|---|
Provider Name | Dr. Lawrence Thomas Eschelman |
First Address | Salem, OR 97302-9712 |
Second Address | Salem, OR 97302-9712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2011 |
Last Update Date | 22/12/2011 |