=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881972677
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BIBHUTI NEUPANE M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/27/2011
-----------------------------------------------------
Last Update Date | 07/12/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3377 RIVERBEND DR
-----------------------------------------------------
City | SPRINGFIELD
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97477-8803
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-222-6389
-----------------------------------------------------
Fax | 541-222-6385
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3377 RIVERBEND DR
-----------------------------------------------------
City | SPRINGFIELD
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97477-8803
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-222-6389
-----------------------------------------------------
Fax | 541-222-6385
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | MD.207181
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208M00000X
-----------------------------------------------------
Taxonomy Name | Hospitalist Physician
-----------------------------------------------------
License Number | MD205272
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------