Individual
DR. EARL DEAN MCNABB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3625 RIVER RD N, #275, KEIZER, OR 97303-5977
(503) 390-0959
(503) 390-1184
Mailing address
PO BOX 20367, KEIZER, OR 97307-0367
(503) 390-0959
(503) 390-1184
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DP00344
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182958
—
OR
01
—
R118188
MEDICARE MAC OFFICE
OR
01
—
R133628
MEDICARE KEIZER OFFICE
OR
Enumeration date
03/23/2006
Last updated
01/16/2008
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