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Organization

KLAMATH PEDIATRIC CLINIC, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN AARON WILSON MD (PRESIDENT)
(541) 883-3591
Entity
Organization

Contact information

Practice address
2310 MOUNTAIN VIEW BLVD, KLAMATH FALLS, OR 97601-1134
(541) 883-3591
(541) 883-2886
Mailing address
2310 MOUNTAIN VIEW BLVD, KLAMATH FALLS, OR 97601-1134
(541) 883-3591
(541) 883-2886

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
029207
OR
Enumeration date
10/17/2006
Last updated
08/22/2020
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