Eric J Wattenburg, MD | |
3818 Sw 21st St, Redmond, OR 97756 | |
(541) 548-2899 | |
(541) 504-3781 |
Full Name | Eric J Wattenburg |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 3818 Sw 21st St, Redmond, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194791640 | NPI | - | NPPES |
00887743 | Other | OR | MEDICARE RAILROAD |
500608820 | Medicaid | OR | |
OOA787640 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | MD29323 (Oregon) | Secondary |
207Q00000X | Family Medicine | A78764 (California) | Secondary |
207Q00000X | Family Medicine | MD29323 (Oregon) | Primary |
Entity Name | Icco Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1407004757 PECOS PAC ID: 1355406729 Enrollment ID: O20090218000510 |
Entity Name | Your Care Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1942548433 PECOS PAC ID: 7315182383 Enrollment ID: O20130321000396 |
Mailing Address | Practice Location Address |
---|---|
Eric J Wattenburg, MD Po Box 4858, Portland, OR 97208-4858 Ph: (541) 500-2500 | Eric J Wattenburg, MD 3818 Sw 21st St, Redmond, OR 97756 Ph: (541) 548-2899 |
Dr. Alan C Hilles, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 865 Sw Veterans Way, Redmond, OR 97756 Phone: 541-322-3500 | |
Nathan R Thompson, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 211 Nw Larch Ave, Redmond, OR 97756 Phone: 541-548-2164 Fax: 541-548-0534 | |
Sheryl L Norris, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 211 Nw Larch Ave, Redmond, OR 97756 Phone: 541-548-2164 Fax: 541-548-0534 | |
James K Detwiler, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 211 Nw Larch Ave, Redmond, OR 97756 Phone: 541-548-2164 Fax: 541-548-0534 | |
Rose J Kenny, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 1001 Nw Canal Blvd Ste 101, Redmond, OR 97756 Phone: 541-548-8088 Fax: 541-548-8018 | |
Dr. Christopher Schuler, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 211 Nw Larch Ave, Redmond, OR 97756 Phone: 541-548-2164 Fax: 541-548-0534 | |
Pamela J Irby, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 211 Nw Larch Ave, Redmond, OR 97756 Phone: 541-548-2164 Fax: 541-548-0534 |