# JOHN D POLANSKY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1942208640
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 09541 | OR | Yes |

## Other

- **Enumeration date:** 07/07/2005
- **Last updated:** 03/15/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0000BHFRC | MEDICARE LEGACY NO. | OR |
| 01 | — | 009139000 | REGENCE BLUE CROSS | OR |
| 05 | — | 161042 | — | OR |
| 01 | — | 180031534 | RAILROAD MEDICARE PTAN | — |