Bouressa, Paul G
Bouressa, Paul G is an individual health care provider with primary practice located at 3377 Riverbend Dr , Springfield OR 97477-8800. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Bouressa, Paul G can be contacted via phone (541) 222-6400.Contact Information
Primary practice address
3377 Riverbend Dr
Springfield OR 97477-8800
Phone: (541) 222-6400
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD20093 | Oregon |
Profile Details
| NPI number | 1366414047 |
|---|---|
| LBN Legal business name | Bouressa, Paul G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 6th, 2006 |
| Last updated | Dec 1st, 2008 - about 16 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366414047 | NPPES |
| Oregon | Other | P370012349 | RAILROAD MEDICARE |
| Oregon | MEDICAID | 082417 | RAILROAD MEDICARE |
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