DR. OLIVER JAYME WISCO


Address: Dermatology Health Spcecialist, 1693 Sw Chandler Ave Suite 250, Bend, OR 97702-3231
Phone: 5413828819

DR. OLIVER JAYME WISCO (NPI# 1164545166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1164545166
Entity Type Individual
Full Name DR. OLIVER JAYME WISCO
Credential D.O.
Practice Address Dermatology Health Spcecialist
1693 Sw Chandler Ave Suite 250
Bend
OR 97702-3231
Mailing Address 110 Elm St
Providence
RI 02903-4626
Practice Telephone 5413828819
Mailing Telephone 4014434992
Enumeration Date 2007-04-06
Last Update Date 2020-08-11
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207N00000X Dermatology DOS-1007 HI Allopathic & Osteopathic Physicians
Y 207ND0101X Dermatology
Specialization: MOHS-Micrographic Surgery
DO01032 RI Allopathic & Osteopathic Physicians
N 207ND0101X Dermatology
Specialization: MOHS-Micrographic Surgery
DO157812 OR Allopathic & Osteopathic Physicians
N 207ND0101X Dermatology
Specialization: MOHS-Micrographic Surgery
243103 MA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
OR CAQH 12729019 01
OR 500674728 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
375 Wampanoag Trl, Riverside, RI 029152232 2106325544 4014326997

Office Location

Street Address DERMATOLOGY HEALTH SPCECIALIST
1693 SW CHANDLER AVE SUITE 250
City BEND
State OR
Zip Code 97702-3231

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1629676259 Amy Michelle Anderson Counselor 233 Sw Wilson Ave, Ste 201, Bend, OR 97702 2020-10-15
1386259463 Jacob Rehder Counselor 19717 Mt Batchelor Dr, #226, Bend, OR 97702 2020-09-15
1497385215 Capacity Performance Therapy Physical Medicine & Rehabilitation 61125 Lodgepole Dr., Bend, OR 97702 2020-01-21
1962041707 Shift Bend Functional Medicine Family Medicine 151 Sw Shevlin Hicks Dr, Suite #1, Bend, OR 97702 2019-12-26
1609435049 Praxis Medical Group Inc Orthopaedic Surgery 1140 Sw Simpson Avenue, Suite 100, Bend, OR 97702 2019-06-10
1013485754 Elana Leah Pesah Social Worker 138 Maaglei Harim Levin, Jerusalem, ISRAEL 97702 2018-11-12
1104303239 Kyleigh Mcvey Massage Therapist 999 Sw Disk Dr, Bend, OR 97702 2018-07-21
1477042869 Siloe Castaneda Huerta Counselor 1340 Nw Wall, Bend, Or, Bend, OR 97702 2018-05-02
1164910808 Rebecca M Joyce Social Worker 1011 Sw Emkay Dr. Suite 101, Bend, OR 97702 2018-04-27
1093217978 Jennifer Bury Acupuncturist 296 Sw Columbia St Ste D1, Bend, OR 97702 2018-03-06
Find all providers in zip 97702

Taxonomy Information

Taxonomy Code 207ND0101X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology
Specialization MOHS-Micrographic Surgery

Taxonomy Definition

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1447713573 Dermatology Health Specialists, PC Dermatology 1693 Sw Chandler Ave Ste 250, Bend, OR 97702-3231 2019-04-06
1780846501 Bend Memorial Clinic PC Dermatology 2600 Ne Neff Rd, Bend, OR 97701-6337 2008-07-02
1184643249 William J Delgado Dermatology 2705 Ne Conners Ave, Bend, OR 97701-6904 2006-07-19

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1871574947 Edgar Maeyens Dermatology 375 Park Ave, Suite 5, Coos Bay, OR 97420-2242 2005-11-07
1972913259 Lindsey Fix Dermatology 1605 G St, Springfield, OR 97477 2014-05-07
1558515494 Jay Y Park Md, PC Dermatology 360 S Garden Way Ste 230, Eugene, OR 97401-8173 2008-11-05
1700081742 Richard I. Ecker Dermatology 706 Ne Evans St, Mcminnville, OR 97128-3926 2007-06-19
1396845814 Parwathi Vasudeva Paniker Dermatology 3600 N Interstate Ave, Portland, OR 97227-1106 2006-09-24
1205805405 Stephen N Snow Dermatology 3600 N Interstate Ave, Dermatology/mohs Surg Central Interstate Medical Office, Portland, OR 97227-1106 2006-03-17

Competitor

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City BEND
Zip Code 97702

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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