Warren, Jerry G
Warren, Jerry G is an sole proprietor health care provider with primary practice located at 621 Se Cass Ave Suite 126, Roseburg OR 97470-3123. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Warren, Jerry G can be contacted via phone (541) 580-0304.Contact Information
Primary practice address
621 Se Cass Ave Suite 126
Roseburg OR 97470-3123
Phone: (541) 580-0304
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD01895 | Oregon |
Profile Details
| NPI number | 1437140043 |
|---|---|
| LBN Legal business name | Warren, Jerry G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 2nd, 2005 |
| Last updated | Aug 29th, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437140043 | NPPES |
| Oregon | MEDICAID | 261735 |
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