Leder, Carl Wallace

Leder, Carl Wallace is an individual health care provider with primary practice located at 621 W Madrone St , Roseburg OR 97470-3090. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Leder, Carl Wallace can be contacted via phone (541) 672-2691.

Contact Information

Primary practice address
621 W Madrone St Roseburg OR 97470-3090
Phone: (541) 672-2691
Fax: (833) 299-8415
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA174113 Oregon

Profile Details

NPI number 1619341724
LBN Legal business name Leder, Carl Wallace
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2015
Last updated Feb 23rd, 2022 - about 2 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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