Detwiler, James K

Detwiler, James K is an individual health care provider with primary practice located at 211 Nw Larch Ave , Redmond OR 97756-1357. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Aerospace Medicine, Allopathic & Osteopathic Physicians / Occupational Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Detwiler, James K can be contacted via phone (541) 548-2164.

Contact Information

Primary practice address
211 Nw Larch Ave Redmond OR 97756-1357
Phone: (541) 548-2164
Fax: (541) 548-0534
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD09568 Oregon
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X MD09568 Oregon
Allopathic & Osteopathic Physicians / Aerospace Medicine 2083A0100X MD09568 Oregon
Allopathic & Osteopathic Physicians / Occupational Medicine 2083X0100X MD09568 Oregon

Profile Details

NPI number 1154364024
LBN Legal business name Detwiler, James K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Feb 7th, 2012 - about 12 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 1154364024 NPPES
Oregon Other 11129522 CAQH ID
Oregon MEDICAID 233692 CAQH ID

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