Individual
DR. TAVIS COWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3680NWSAMARITAN DR, CORVALLIS, OR 97330-3737
(541) 754-1150
Mailing address
444NWELKS DR, CORVALLIS, OR 97330-3745
(541) 754-1150
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042-0011895
VT
207Q00000X
Family Medicine Physician
MD172092
OR
261QU0200X
Urgent Care Clinic/Center
0420011895
VT
Other
Enumeration date
06/15/2006
Last updated
08/03/2015
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