MEDICARE: DR. JAMES F CALVERT JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD18000	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	E63721	OTHER	OR	CHAMPUS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477578961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES F CALVERT JR. MD

Provider Business Mailing Address
First Line	:	2865 DAGGETT AVE
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-1106
Country	:	US
Telephone Number	:	541-883-6221
Fax Number	:	541-883-6247

Provider Business Practice Location Address
First Line	:	2801 DAGGETT AVE
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-1106
Country	:	US
Telephone Number	:	541-883-6221
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	07/09/2007

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