Wisco, Oliver Jayme

Wisco, Oliver Jayme is an individual health care provider with primary practice located at Dermatology Health Spcecialist 1693 Sw Chandler Ave Suite 250, Bend OR 97702-3231. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Wisco, Oliver Jayme can be contacted via phone (541) 382-8819.

Contact Information

Primary practice address
Dermatology Health Spcecialist 1693 Sw Chandler Ave Suite 250 Bend OR 97702-3231
Phone: (541) 382-8819
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X DOS-1007 Hawaii
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 243103 Massachusetts
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X DO157812 Oregon
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X DO01032 Rhode Island

Profile Details

NPI number 1164545166
LBN Legal business name Wisco, Oliver Jayme
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2007
Last updated Aug 11th, 2020 - 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 1164545166 NPPES
Oregon Other 12729019 CAQH
Oregon MEDICAID 500674728 CAQH

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