Pennell-Walklin, Ian James

Pennell-Walklin, Ian James is an individual health care provider with primary practice located at 3600 Nw Samaritan Dr , Corvallis OR 97330-3737. He recently has 3 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Pennell-Walklin, Ian James can be contacted via phone (541) 768-5111.

Contact Information

Primary practice address
3600 Nw Samaritan Dr Corvallis OR 97330-3737
Phone: (541) 768-5111
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X MD172217 Oregon
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD172217 Oregon

Profile Details

NPI number 1952662892
LBN Legal business name Pennell-Walklin, Ian James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2012
Last updated Jan 14th, 2021 - about 4 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 1952662892 NPPES
Oregon MEDICAID 500688436

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