Healthcare Provider Details

I. General information

NPI: 1437166311
Provider Name (Legal Business Name): DONALD J VENES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 02/16/2021
Certification Date: 02/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 DAGGETT AVE STE 200
KLAMATH FALLS OR
97601-1130
US

IV. Provider business mailing address

2865 DAGGETT AVE
KLAMATH FALLS OR
97601-1106
US

V. Phone/Fax

Practice location:
  • Phone: 541-274-8400
  • Fax: 541-469-9204
Mailing address:
  • Phone: 541-274-8400
  • Fax: 541-274-8405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG83774
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD16232
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: