| William Trueblood Pc | |
|
26 Nw Irving Ave Bend OR 97701-2012 | |
| (541) 385-5203 | |
| Not Available |
| Full Name | William Trueblood Pc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 26 Nw Irving Ave, Bend, Oregon |
| Authorized Official Name and Position | William Trueblood Trueblood (PRESIDENT) |
| Authorized Official Contact | 5413855203 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| William Trueblood Pc 26 Nw Irving Ave Bend OR 97701-2012 Ph: () - | William Trueblood Pc 26 Nw Irving Ave Bend OR 97701-2012 Ph: (541) 385-5203 |
| NPI Number | 1467752303 |
|---|---|
| Provider Enumeration Date | 10/26/2010 |
| Last Update Date | 10/26/2010 |
| Medicare PECOS PAC ID | 3476739285 |
|---|---|
| Medicare Enrollment ID | O20110512000047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467752303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 1200 (Oregon) | Primary |
| Provider Name | Glenn W Trueblood |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811014012 PECOS PAC ID: 2163608977 Enrollment ID: I20110512000099 |
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