Healthcare Provider Details

I. General information

NPI: 1114906443
Provider Name (Legal Business Name): JOHN M TERHES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 09/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 S GARDEN WAY SUITE 290
EUGENE OR
97401-8173
US

IV. Provider business mailing address

360 S GARDEN WAY SUITE 290
EUGENE OR
97401-8173
US

V. Phone/Fax

Practice location:
  • Phone: 541-345-2205
  • Fax: 541-345-4480
Mailing address:
  • Phone: 541-345-2205
  • Fax: 541-345-4480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD25082
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD25082
License Number StateOR

VII. Legacy identifiers

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

# 1
Identifier275338
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: