Dauterman, Kent W
Dauterman, Kent W is an individual health care provider with primary practice located at 520 Medical Center Dr Suite 200, Medford OR 97504-4314. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Dauterman, Kent W can be contacted via phone (541) 282-6600.Contact Information
Primary practice address
520 Medical Center Dr Suite 200
Medford OR 97504-4314
Phone: (541) 282-6600
Fax: (541) 282-6601
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | MD24049 | Oregon |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | MD24049 | Oregon |
Profile Details
| NPI number | 1255329728 |
|---|---|
| LBN Legal business name | Dauterman, Kent W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 10th, 2005 |
| Last updated | Jan 6th, 2015 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255329728 | NPPES |
| Oregon | MEDICAID | 227698 | |
| Oregon | MEDICAID | 226915 |
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