Brewer, Jack Alan
Brewer, Jack Alan is an individual health care provider with primary practice located at 2090 Ne Wyatt Ct Suite 101, Bend OR 97701-7687. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Brewer, Jack Alan can be contacted via phone (541) 382-6447.Contact Information
Primary practice address
2090 Ne Wyatt Ct Suite 101
Bend OR 97701-7687
Phone: (541) 382-6447
Fax: (541) 330-7413
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | MD14911 | Oregon |
Profile Details
| NPI number | 1518929439 |
|---|---|
| LBN Legal business name | Brewer, Jack Alan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 5th, 2006 |
| Last updated | Jan 9th, 2017 - about 7 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 | 1518929439 | NPPES |
| Oregon | MEDICAID | 113050 |
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