Webster, William Wallace
Webster, William Wallace is an sole proprietor health care provider with primary practice located at 1900 Woodland Drive , Coos Bay OR 97420-0000. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Allergy & Immunology, Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Otolaryngology. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Webster, William Wallace can be contacted via phone (541) 267-5151.Contact Information
Primary practice address
1900 Woodland Drive
Coos Bay OR 97420-0000
Phone: (541) 267-5151
Fax: (541) 266-4580
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | A40097 | California |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | A40097 | California |
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | MD27455 | Oregon |
Profile Details
| NPI number | 1528166287 |
|---|---|
| LBN Legal business name | Webster, William Wallace |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Mar 23rd, 2010 - about 14 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 | 1528166287 | NPPES |
| Oregon | Other | CB3544 | TRAV RR MEDICARE GROUP PTAN |
| Oregon | MEDICAID | 274244 | TRAV RR MEDICARE GROUP PTAN |
| Oregon | Other | 1407812365 | TRAV RR MEDICARE GROUP PTAN |
| Oregon | Other | R0000WFBTV | TRAV RR MEDICARE GROUP PTAN |
| Oregon | Other | P00628020 | TRAV RR MEDICARE GROUP PTAN |
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