Healthcare Provider Details

I. General information

NPI: 1518036334
Provider Name (Legal Business Name): JOHN SHARRER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 08/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 COBURG RD STE 301
EUGENE OR
97401-4982
US

IV. Provider business mailing address

1755 COBURG RD STE 301
EUGENE OR
97401-4982
US

V. Phone/Fax

Practice location:
  • Phone: 541-344-8225
  • Fax: 541-744-7322
Mailing address:
  • Phone: 541-344-8225
  • Fax: 541-744-7322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number14230
License Number StateOR

VII. Legacy identifiers

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

# 1
Identifier107045
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: