Prabhu, Somnath Jagannath

Prabhu, Somnath Jagannath is an individual health care provider with primary practice located at 938 Nw Kings Blvd , Corvallis OR 97330-2505. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Prabhu, Somnath Jagannath can be contacted via phone (541) 758-5047.

Contact Information

Primary practice address
938 Nw Kings Blvd Corvallis OR 97330-2505
Phone: (541) 758-5047
Fax: (541) 758-3713
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ML60026972 Washington
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD60479844 Washington
Allopathic & Osteopathic Physicians / Surgery 208600000X ML60026972 Washington
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD199646 Oregon

Profile Details

NPI number 1689825135
LBN Legal business name Prabhu, Somnath Jagannath
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2008
Last updated Jan 18th, 2021 - about 3 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 1689825135 NPPES
Washington MEDICAID 2018572

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