Individual
JEFFREY T WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5900 INLAND SHORES WAY N, KEIZER, OR 97303-3883
(503) 399-2424
(503) 375-7429
Mailing address
PO BOX 8100, SALEM, OR 97303-0900
(503) 399-2424
(503) 375-7429
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD18359
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110165016
RAILROAD MEDICARE
—
05
—
150887
—
OR
01
—
CS4159
RAILROAD GROUP
—
Enumeration date
06/15/2006
Last updated
01/17/2018
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