Wilks, G Jason

Wilks, G Jason is an sole proprietor health care provider with primary practice located at 1813 W Harvard Ave Ste 201 , Roseburg OR 97471-2754. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Wilks, G Jason can be contacted via phone (541) 673-0742.

Contact Information

Primary practice address
1813 W Harvard Ave Ste 201 Roseburg OR 97471-2754
Phone: (541) 673-0742
Fax: (541) 673-7553
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X DP00318 Oregon

Profile Details

NPI number 1316006539
LBN Legal business name Wilks, G Jason
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 6th, 2006
Last updated Oct 12th, 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 1316006539 NPPES
Oregon Other 067946000 REGENCE
Oregon Other 7600580001 REGENCE
Oregon Other DX4938 REGENCE
Oregon MEDICAID 500720262 REGENCE
Oregon Other 430895102 REGENCE
Oregon Other 480028890 REGENCE
Oregon Other R192914 REGENCE
Oregon Other D201111 REGENCE

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