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General NPI Number Information
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NPI Number | 1750380440
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Entity Type | Organization
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Legal Business Name | JOHNSON & CADE FAMILY PRACTICE LLC
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2088 NE KIM LN STE A
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City | BEND
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State | OR
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Zip | 97701-6588
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Country | US
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Telephone | 541-389-4600
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Fax | 541-312-9600
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Provider Business Mailing Address
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Address Line | 2088 NE KIM LN STE A
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City | BEND
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State | OR
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Zip | 97701-6588
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Country | US
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Telephone | 541-389-4600
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Fax | 541-312-9600
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. TERRI KAY DUNSCOMB
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Credential |
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Telephone | 541-389-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | OR
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