Healthcare Provider Details

I. General information

NPI: 1609437839
Provider Name (Legal Business Name): MUHAMMAD HASSAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2019
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3783 INTERNATIONAL CT STE 290
SPRINGFIELD OR
97477-1025
US

IV. Provider business mailing address

3783 INTERNATIONAL CT STE 390
SPRINGFIELD OR
97477-1025
US

V. Phone/Fax

Practice location:
  • Phone: 541-687-1927
  • Fax: 513-984-4240
Mailing address:
  • Phone: 541-687-1927
  • Fax: 541-683-8779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35.147431
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number224597
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: