Healthcare Provider Details

I. General information

NPI: 1033379847
Provider Name (Legal Business Name): DAVID A. BOVE, ND PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1161 LINCOLN ST
EUGENE OR
97401-3417
US

IV. Provider business mailing address

1161 LINCOLN ST
EUGENE OR
97401-3417
US

V. Phone/Fax

Practice location:
  • Phone: 541-683-2126
  • Fax:
Mailing address:
  • Phone: 541-683-2126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier227955
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerOMAP

VIII. Authorized Official

Name: DAVID A. BOVE
Title or Position: CHAIRMAN
Credential: N.D.
Phone: 541-683-2126