Healthcare Provider Details

I. General information

NPI: 1548197262
Provider Name (Legal Business Name): JOHN FRANCIS GERDES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 MAIN ST
KLAMATH FALLS OR
97601-2629
US

IV. Provider business mailing address

4751 BELLM DR SPC 305
KLAMATH FALLS OR
97603-8902
US

V. Phone/Fax

Practice location:
  • Phone: 541-238-2289
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number116809
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: