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General NPI Number Information
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NPI Number | 1720169014
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Entity Type | Organization
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Legal Business Name | WIND RIVER ANESTHESIA CONSULTANTS INC
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 02/21/2018
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Provider Practice Location Address
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Address Line | 2865 DAGGETT AVE
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City | KLAMATH FALLS
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State | OR
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Zip | 97601
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Country | US
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Telephone | 541-882-6311
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Fax | 530-243-0445
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Provider Business Mailing Address
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Address Line | 20915 ROYAL OAK CIRCLE
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City | BEND
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State | OR
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Zip | 97701
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Country | US
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Telephone | 307-349-9570
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Fax | 530-243-0445
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDWARD J FRINK JR.
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Credential | MD
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Telephone | 307-349-9570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD182286
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License Number State | OR
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