Healthcare Provider Details

I. General information

NPI: 1740272533
Provider Name (Legal Business Name): ERIC J PUTZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

885 MISSION ST SE
SALEM OR
97302-6222
US

IV. Provider business mailing address

885 MISSION ST SE
SALEM OR
97302-6222
US

V. Phone/Fax

Practice location:
  • Phone: 503-814-0273
  • Fax: 503-814-0299
Mailing address:
  • Phone: 503-814-0273
  • Fax: 503-814-0299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD23705
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number18820-20
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD23705
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: