Chotechuang, Tajyant Nat

Chotechuang, Tajyant Nat is an individual health care provider with primary practice located at 1510 Sw Nancy Way Ste 2 , Bend OR 97702-3256. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Chotechuang, Tajyant Nat can be contacted via phone (541) 385-7129.

Contact Information

Primary practice address
1510 Sw Nancy Way Ste 2 Bend OR 97702-3256
Phone: (541) 385-7129
Fax: (541) 385-7138
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X DP00339 Oregon
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X DP00339 Oregon

Profile Details

NPI number 1396757431
LBN Legal business name Chotechuang, Tajyant Nat
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2006
Last updated Jul 22nd, 2011 - about 15 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 1396757431 NPPES
Oregon Other 20-2456582 TAX ID
Oregon Other 865318005 TAX ID
Oregon MEDICAID 181419 TAX ID

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