Healthcare Provider Details

I. General information

NPI: 1033394986
Provider Name (Legal Business Name): RONALD D WOBIG MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 10/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1128 NE 2ND ST SUITE 201
CORVALLIS OR
97330-6230
US

IV. Provider business mailing address

1128 NE 2ND ST STE 201
CORVALLIS OR
97330-6298
US

V. Phone/Fax

Practice location:
  • Phone: 541-757-8100
  • Fax: 541-754-2707
Mailing address:
  • Phone: 541-757-8100
  • Fax: 541-754-2707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RONALD D WOBIG
Title or Position: OWNER
Credential: MD
Phone: 541-757-8100