Organization
PROTEAN DERMATOLOGY CONSULTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN E JACKSON MD (PHYSICIAN OWNER)
(855) 457-5593
Entity
Organization
Contact information
Practice address
360 SW BOND ST STE 310, BEND, OR 97702-3556
(855) 457-5593
Mailing address
360 SW BOND ST STE 310, BEND, OR 97702-3556
(855) 457-5593
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
11/26/2024
Last updated
11/26/2024
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