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NPI Code Detail

MEDICARE: DR. ERLING JOHANNES OKSENHOLT D.O.

MEDICARE: DR. ERLING JOHANNES OKSENHOLT D.O.
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
1207P00000XEmergency Medicine PhysicianDO08519OR
2207QG0300XGeriatric Medicine (Family Medicine) PhysicianDO08519OR
3207Q00000XFamily Medicine PhysicianDO08519OR

General Provider Information

NPI Number : 1811069404
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERLING JOHANNES OKSENHOLT D.O.
Provider Business Mailing Address
First Line : PO BOX 1194
Second Line :
City : CORVALLIS
State : OR
Zip : 97339-1194
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2870 NE WEST DEVILS LAKE RD
Second Line :
City : LINCOLN CITY
State : OR
Zip : 97367-5127
Country : US
Telephone Number : 541-994-9191
Fax Number : 541-994-9034
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2006
Last Update Date : 11/04/2020

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