Doctor Name: | DR. BENJAMIN RAY ELIASON |
NPI Number: | 1659418267 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | MD125756 |
Business Practice Address: | 1345 Nw Wall St Bend, OR - 977011972 |
Business Phone Number: | 5413821395 |
Business Fax Number: | 5413826576 |
Mailing Address: | 62709 Larkview Rd, BEND |
State: | OR |
Postal Code: | 977017529 |
Phone Number: | 5416783697 |
Fax Number: | |
NPI Enumeration Date: | 01/31/2007 |
NPI Last Update Date: | 08/27/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261Q00000X |
License Number: | MD125756 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OR |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |