Carlson, Bruce D
Carlson, Bruce D is an sole proprietor health care provider with primary practice located at 236 E Newport Ave , Hermiston OR 97838-2449. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Carlson, Bruce D can be contacted via phone (541) 567-1137.Contact Information
Primary practice address
236 E Newport Ave
Hermiston OR 97838-2449
Phone: (541) 567-1137
Fax: (541) 567-2336
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD07786 | Oregon |
Profile Details
| NPI number | 1669537106 |
|---|---|
| LBN Legal business name | Carlson, Bruce D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 26th, 2006 |
| Last updated | Dec 29th, 2015 - about 10 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 | 1669537106 | NPPES |
| Oregon | Other | 080385000 | BLUE CROSS BLUE SHIELD |
| Oregon | MEDICAID | 182817 | BLUE CROSS BLUE SHIELD |
| Oregon | MEDICAID | 223149 | BLUE CROSS BLUE SHIELD |
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