MEDICARE: DOUGLAS H. TODD, M.D., P.C.

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	207Y00000X	Otolaryngology Physician	MD15860	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	E67442	OTHER	OR	UPIN

General Provider Information

NPI Number	:	1669658878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOUGLAS H. TODD, M.D., P.C.

Provider Business Mailing Address
First Line	:	3000 BRYANT WILLIAMS DR
Second Line	:	SUITE 200
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-1139
Country	:	US
Telephone Number	:	541-274-3000
Fax Number	:	541-274-2305

Provider Business Practice Location Address
First Line	:	3000 BRYANT WILLIAMS DR
Second Line	:	SUITE 200
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-1139
Country	:	US
Telephone Number	:	541-274-3000
Fax Number	:	541-274-2305

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DOUGLAS HAYMORE TODD
Credential	:	M.D.
Telephone Number	:	541-274-3000

Provider Enumeration Date	:	01/17/2008
Last Update Date	:	03/05/2008

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