Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | DP198814 | OR |
N | 222Z00000X | Podiatrist | DP198814 | OR |
N | 213EP1101X | Primary Podiatric Medicine | NOT YET ISSUED | TX |
N | 111NR0200X | Radiology | NOT YET ISSUED | TX |
N | 213ER0200X | Radiology | NOT YET ISSUED | TX |
Y | 213ES0103X | Foot & Ankle Surgery | DP198814 | OR |
N | 213ES0103X | Foot & Ankle Surgery | NOT YET ISSUED | TX |
NPI | 1750817714 |
---|---|
Provider Name | John Sessions |
First Address | Keizer, OR 97303-5506 |
Second Address | Keizer, OR 97303-5506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2017 |
Last Update Date | 03/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500782216 | (05) | OR |