Carpenter, Kevin R

Carpenter, Kevin R is an individual health care provider with primary practice located at 440 Nw Division St , Gresham OR 97030-5506. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Carpenter, Kevin R can be contacted via phone (503) 215-9500.

Contact Information

Primary practice address
440 Nw Division St Gresham OR 97030-5506
Phone: (503) 215-9500
Fax: (503) 215-9525
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD20344 Oregon

Profile Details

NPI number 1578509980
LBN Legal business name Carpenter, Kevin R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Feb 18th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578509980 NPPES
Oregon Other 080102978 RR MEDICARE (PH&S)-PMG
Oregon MEDICAID 150062 RR MEDICARE (PH&S)-PMG

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