Countiss, John Spencer

Countiss, John Spencer is an individual health care provider with primary practice located at 495 Sw Ramsey Ave , Grants Pass OR 97527. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Countiss, John Spencer can be contacted via phone (541) 476-6644.

Contact Information

Primary practice address
495 Sw Ramsey Ave Grants Pass OR 97527
Fax: (541) 472-5673
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD057054 Oregon

Profile Details

NPI number 1144225921
LBN Legal business name Countiss, John Spencer
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated Jul 8th, 2007 - about 18 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 1144225921 NPPES
Oregon MEDICAID 057054

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