Bose, Brent Jerrod

Bose, Brent Jerrod is an individual health care provider with primary practice located at 842 E Main St , Medford OR 97504-7134. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, which is considered as his primary health care specialty. Bose, Brent Jerrod can be contacted via phone (541) 618-5800.

Contact Information

Primary practice address
842 E Main St Medford OR 97504-7134
Phone: (541) 618-5800
Fax: (541) 779-3027
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 15785 New Hampshire
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X MD161662 Oregon

Profile Details

NPI number 1841435047
LBN Legal business name Bose, Brent Jerrod
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 3rd, 2008
Last updated Jan 31st, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841435047 NPPES
Oregon MEDICAID 500657645
Oregon Other R170676

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