Individual
KARL C WENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2821 DAGGETT AVE STE 100, KLAMATH FALLS, OR 97601-1106
(541) 274-6733
(541) 274-2006
Mailing address
2865 DAGGETT AVE, KLAMATH FALLS, OR 97601-1106
(541) 274-6564
(541) 274-6247
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD15968
OR
207XS0117X
Orthopaedic Surgery of the Spine Physician
MD15968
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
098830
—
OR
01
—
XPY113830
MEDI-CAL
OR
Enumeration date
07/25/2006
Last updated
03/07/2023
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