Gordon Earl Banks, PH.D.,M.D.
Individual provider Active NPI Specialist · McMinnville, OR
NPI 1699701227 · NPPES record last updated Dec 16, 2011
Key facts
- NPI
- 1699701227
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- MD21516 (OR)
- Practice address
- 2700 SE Stratus Ave
Suite 304
McMinnville, OR 97128-6255 - Phone
- (503) 434-6090
- Fax
- (503) 474-3306
- NPI assigned
- Jun 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine, Doctor of Philosophy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MD21516 | OR | Yes |
Addresses
Primary practice location
2700 SE Stratus Ave
Suite 304
McMinnville, OR 97128-6255
Mailing address
2700 SE Stratus Ave
Suite 304
McMinnville, OR 97128-6255
Phone (503) 434-6090
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 603273000 | Other | OR | US DEPARTMENT OF LABOR |
| 130022916 | Other | OR | RAILROAD MEDICARE |
| 134029 | Medicaid | OR |
Other providers in McMinnville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.