Organization
KLAMATH ORTHOPEDIC CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNETTE GANSBERG (EXECUTIVE DIRECTOR)
(541) 274-2902
Entity
Organization
Contact information
Practice address
2200 BRYANT WILLIAMS DR, SUITE 1, KLAMATH FALLS, OR 97601-1120
(541) 884-7746
(541) 274-5705
Mailing address
2200 BRYANT WILLIAMS DRIVE, SUITE 1, KLAMATH FALLS, OREGON 97601-1121
(541) 884-7746
(541) 274-5705
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002635000
BLUE CROSS
OR
01
—
200010673
RAILROAD MEDICARE
OR
01
—
200044954
RAILROAD MEDICARE
OR
05
—
261198
—
OR
05
—
284783
—
OR
05
—
500679872
—
OR
01
—
CO3632
RAIL ROAD MEDICARE
OR
01
—
P01432107
RAILROAD MEDICARE
OR
01
—
P01702513
RAILROAD MEDICARE
OR
01
—
P01815487
RAIL ROAD MEDICARE
OR
Enumeration date
07/25/2006
Last updated
06/19/2024
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