Organization Name: | KARL C WENNER MD PC |
NPI Number: | 1043430747 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEANNETTE L GANSBERG (EXECUTIVE DIRECTOR) |
Mailing Address: | 2200 Bryant Williams Dr Suite 1 Klamath Falls |
State: | OR US |
Postal Code: | 976011120 |
Phone Number: | 5418847746 |
Fax Number: | 5418840848 |
NPI Enumeration Date: | 04/26/2007 |
NPI Last Update Date: | 11/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD15968 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |