Healthcare Provider Details

I. General information

NPI: 1528271707
Provider Name (Legal Business Name): PATRICIA O BUEHLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 NE MARY ROSE PL SUITE 110
BEND OR
97701
US

IV. Provider business mailing address

2450 NE MARY ROSE PLACE SUITE 110
BEND OR
97701-8606
US

V. Phone/Fax

Practice location:
  • Phone: 541-318-8388
  • Fax: 541-318-7145
Mailing address:
  • Phone: 541-318-8388
  • Fax: 541-318-7145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD17853
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier072970
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: