Individual
JOHN K MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
2200 BRYANT WILLIAMS DR, SUITE 1, KLAMATH FALLS, OR 97601-1121
(541) 884-7746
(541) 884-0848
Mailing address
2200 BRYANT WILLIAMS DR, SUITE 1, KLAMATH FALLS, OR 97601-1121
(541) 884-7746
(541) 884-0848
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201604411NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500710776
—
OR
01
—
P01702513
RAILROAD MEDICARE
OR
Enumeration date
08/09/2016
Last updated
10/03/2016
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