Organization
O L PUTTLER JR MD A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLIVER L PUTTLER JR. MD (OWNER)
(707) 822-1131
Entity
Organization
Contact information
Practice address
3798 JANES RD, SUITE 15, ARCATA, CA 95521-4753
(707) 822-1131
(707) 822-0746
Mailing address
3798 JANES RD, SUITE 15, ARCATA, CA 95521-4753
(707) 822-1131
(707) 822-0746
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
G13904
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G139040
—
CA
Enumeration date
08/10/2011
Last updated
09/12/2017
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