Individual
DAVID BURT INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 SUNSET DR, LA GRANDE, OR 97850-1387
(541) 963-8421
(541) 963-1476
Mailing address
PO BOX 3290, LA GRANDE, OR 97850-7290
(541) 963-8421
(541) 963-1476
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
BP10061467
TX
207P00000X
Emergency Medicine Physician
Primary
MD198197
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500778372
—
OR
Enumeration date
06/02/2017
Last updated
08/13/2020
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