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Individual

MR. JOHN R LADD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3680 NW SAMARITAN DR, CORVALLIS, OR 97330-3737
(541) 754-1150
Mailing address
3680 NW SAMARITAN DR, CORVALLIS, OR 97330-3737

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD07353
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110162961
MEDICARE RAILROAD
05
242693
OR
Enumeration date
05/09/2006
Last updated
01/06/2009
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