James D Bauer, M.D.

Individual provider Active NPI Obstetrics & Gynecology Physician · Redmond, OR

NPI 1972545127 · NPPES record last updated Jan 26, 2016

Key facts

NPI
1972545127
Entity type
Individual (NPI type 1)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
License
MD17396 (OR)
Practice address
340 NW 5TH St
Suite 101
Redmond, OR 97756-1869
Phone
(541) 526-6635
Fax
(541) 526-6636
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1452SDMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD17396 OR Yes

Addresses

Primary practice location

340 NW 5TH St
Suite 101
Redmond, OR 97756-1869

Mailing address

PO Box 5579
Bend, OR 97708-5579
Phone (541) 526-6635

Other identifiers

IdentifierTypeStateIssuer
MD17396OtherORSTATE LICENSE
P00247375OtherORRR MEDICARE

Other providers in Redmond, OR

All providers in Redmond, OR · Obstetrics & Gynecology Physician in Oregon

Sources for this page

Verify at the official NPI Registry.