Thomas Richard Eubanks, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

DO23077 Issued in OR

Practice address

9200 SE 91St Ave
Ste 320
Portland, OR 97086-6756

Phone

(503) 353-3005

Fax

(503) 546-3201

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307491200000",
    "number": "1730274168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 SE 91ST AVE",
            "address_2": "STE 320",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "970866756",
            "telephone_number": "503-353-3005",
            "fax_number": "503-546-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 SE 91ST AVE",
            "address_2": "STE 320",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "970866756",
            "telephone_number": "503-353-3005",
            "fax_number": "503-546-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUBANKS",
        "first_name": "THOMAS",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2011-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "DO23077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287443",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BC/BS OR",
            "identifier": "858363002",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Eubanks
• David Lee Eubanks, QMHA
• John Charles Eubanks
• Marilyn Sue Eubanks
• Sean Robert Eubanks
• Eudaemonia Equine Connections, Inc.
• Eudaemonia Equine Connections, Inc.
• Eugene Borkan, MD, PC
• Eugenia Salomon MFT
• Jasmine K.K. Eugenio

• Surgery Physician in Portland, OR
• Providers in Portland, OR by specialty
• Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.