Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | MD08786 | OR |
NPI | 1003822230 |
---|---|
Provider Name | John York |
First Address | Eugene, OR 97401-0120 |
Second Address | Eugene, OR 97401-6025 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 20/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
231027 | (05) | OR |
C91042 | (02) | OR |