Millet, Brock W.

Millet, Brock W. is an individual 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. Millet, Brock W. can be contacted via phone (541) 396-7295.

Contact Information

Primary practice address
790 E 5Th St Coquille OR 97423-1755
Phone: (541) 396-7295
Fax: (541) 396-7295
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD162167 Oregon

Profile Details

NPI number 1265758973
LBN Legal business name Millet, Brock W.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2010
Last updated Jan 27th, 2014 - about 12 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 1265758973 NPPES
Oregon Other 161133 GROUP MEDICAID NORTH BEND MEDICAL CENTER
Oregon Other R0000WFBTV GROUP MEDICAID NORTH BEND MEDICAL CENTER
Oregon MEDICAID 500656979 GROUP MEDICAID NORTH BEND MEDICAL CENTER
Oregon Other P0125299 GROUP MEDICAID NORTH BEND MEDICAL CENTER
Oregon Other 930635514 GROUP MEDICAID NORTH BEND MEDICAL CENTER
Oregon Other 1407812365 GROUP MEDICAID NORTH BEND MEDICAL CENTER
Oregon Other MD162167 GROUP MEDICAID NORTH BEND MEDICAL CENTER

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