Brazer, John William

Brazer, John William is an sole proprietor health care provider with primary practice located at 790 E 5Th St , Coquille OR 97423-1755. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Brazer, John William can be contacted via phone (541) 396-3111.

Contact Information

Primary practice address
790 E 5Th St Coquille OR 97423-1755
Phone: (541) 396-3111
Fax: (541) 396-5222
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD07716 Oregon

Profile Details

NPI number 1306821731
LBN Legal business name Brazer, John William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 8th, 2005
Last updated Mar 23rd, 2010 - about 16 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 1306821731 NPPES
Oregon Other 080059412 RR MEDICARE PTAN NUMBER
Oregon MEDICAID 011239 RR MEDICARE PTAN NUMBER
Oregon Other CD8723 RR MEDICARE PTAN NUMBER
Oregon Other 930635514 RR MEDICARE PTAN NUMBER
Oregon Other MD07716 RR MEDICARE PTAN NUMBER
Oregon Other R0000WFBTV RR MEDICARE PTAN NUMBER
Oregon Other 1407812365 RR MEDICARE PTAN NUMBER

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