Rutherford, Brock

Rutherford, Brock is an individual health care provider with primary practice located at 2200 Ne Neff Rd Ste 200 , Bend OR 97701-4281. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Rutherford, Brock can be contacted via phone (541) 382-3344.

Contact Information

Primary practice address
2200 Ne Neff Rd Ste 200 Bend OR 97701-4281
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 192493 Oregon

Profile Details

NPI number 1841640430
LBN Legal business name Rutherford, Brock
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2016
Last updated May 9th, 2022 - about 3 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 1841640430 NPPES
Oregon Other 192493 OREGON MEDICAL BOARD
Oregon MEDICAID 500762847 OREGON MEDICAL BOARD

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