Evergreen Oculofacial Plastic Surgery Llc
LBN: Evergreen Oculofacial Plastic Surgery Llc
Evergreen Oculofacial Plastic Surgery Llc is an health care organization with primary practice located at 929 Sw Simpson Ave Ste 250 , Bend OR 97702-3599. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery, which is considered as the primary health care specialty.
Evergreen Oculofacial Plastic Surgery Llc can be contacted via phone (541) 585-0505, or through Goecks, Tara Marie via phone (303) 228-3220.
Contact Information
Primary practice address
929 Sw Simpson Ave Ste 250
Bend OR 97702-3599
Phone: (541) 585-0505
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery | 207WX0200X |
Profile Details
| NPI number | 1669133492 |
|---|---|
| LBN Legal business name | Evergreen Oculofacial Plastic Surgery Llc |
| DBA Doing business as | |
| Authorized official | Goecks, Tara Marie Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 4th, 2022 |
| Last updated | Mar 20th, 2024 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669133492 | NPPES |
| Colorado | Other | 1598051732 | ANTHEM |
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