Healthcare Provider Details

I. General information

NPI: 1861604217
Provider Name (Legal Business Name): MICHAEL JAMES WILWAND DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2007
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 BRYANT WILLIAMS DR STE 1
KLAMATH FALLS OR
97601-1121
US

IV. Provider business mailing address

2200 BRYANT WILLIAMS DR STE 1
KLAMATH FALLS OR
97601-1121
US

V. Phone/Fax

Practice location:
  • Phone: 541-884-7746
  • Fax: 541-274-5705
Mailing address:
  • Phone: 541-882-6311
  • Fax: 541-274-6247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberOP00002294
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number5101015498
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberDO228949
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: