DR. JACK ALAN BREWER (NPI# 1518929439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518929439 |
| Entity Type | Individual |
| Full Name | DR. JACK ALAN BREWER |
| Credential | MD |
| Practice Address |
2090 Ne Wyatt Ct Suite 101 Bend OR 97701-7687 |
| Practice Telephone | 5413826447 |
| Practice Fax Number | 5413307413 |
| Mailing Telephone | 5413826447 |
| Mailing Fax Number | 5413307413 |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2017-01-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | MD14911 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 113050 | 05 |
| Street Address |
2090 NE WYATT CT SUITE 101 |
| City | BEND |
| State | OR |
| Zip Code | 97701-7687 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962464271 | Nora Vanessa Takla | Urology | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2006-04-03 |
| 1104217744 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 2090 Ne Wyatt Ct, Ste 201, Bend, OR 97701-7687 | 2015-02-17 |
| 1730355488 | Michelle L Fitts | Physician Assistant | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2008-05-02 |
| 1316161680 | Meredith Rae Baker | Urology | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2007-04-11 |
| 1992838866 | Frank Cobarrubia Dpmpc | Podiatrist | 2090 Ne Wyatt Ct, Ste. 201, Bend, OR 97701-7687 | 2007-03-13 |
| 1124078738 | William J Corrigan | Urology | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2006-05-12 |
| 1831149079 | Timothy Krigbaum | Physician Assistant | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2006-05-10 |
| 1508815754 | Bend Urology Associates, LLC | Urology | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2006-05-07 |
| 1417906660 | Doctors Park Surgery Center, LLC | Clinic/Center | 2090 Ne Wyatt Ct, Suite 102, Bend, OR 97701-7687 | 2006-05-07 |
| 1629030523 | Brian Timothy O'hollaren | Urology | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2006-04-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104465525 | Andrew Kyle Burzynski | Denturist | 853 Ne 4th St., Bend, OR 97701 | 2020-01-02 |
| 1013480714 | Andrew Traut | Specialist/Technologist | Oregon State Force Lab, 2200 Ne Neff Rd Suite 202, Bend, OR 97701 | 2019-01-04 |
| 1871063917 | Calley Asbill, Nd LLC | Chiropractor | 2146 Ne 4th Street, Suite 160, Bend, OR 97701 | 2018-12-02 |
| 1902372212 | Carisa S Battin | Counselor | 361 Ne Franklin Avenue Bldg E #4, Bend, OR 97701 | 2018-10-15 |
| 1366921223 | Hillside Eye Center LLC | Ophthalmology | 625 Nw Colorado Avenue, Bend, OR 97701 | 2018-08-11 |
| 1528545514 | Kellie Michiko Kawasaki-jones | Dentist | 62968 Ob Riley Road, Suite 12, Bend, OR 97701 | 2018-07-23 |
| 1992255327 | Shelby Chiropractic | Chiropractor | 561 Ne Bellevue Dr Ste 102, Bend, OR 97701 | 2016-10-10 |
| 1144671520 | Kevin Richard Pett | Acupuncturist | 39 Nw Louisanna Ave., Hawthorn Healing Arts Center, Bend, OR 97701 | 2016-06-27 |
| 1912357500 | Sheldon Shawn Doveri | Driver | 233 Nw Revere Ave, Bend, OR 97701 | 2016-06-15 |
| 1740647411 | Anne Power | Homeopath | 2100 Ne Neff Rd Suite B, Bend, OR 97701 | 2016-01-26 |
| Find all providers in zip 97701 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962464271 | Nora Vanessa Takla | Urology | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2006-04-03 |
| 1013294941 | Matt S Ashley | Urology | 2090 Ne Wyatt Ct Ste 101, Bend, OR 97701-7691 | 2011-11-06 |
| 1356570055 | Marta S Johnson-mitchell | Urology | 1247 Ne Medical Center Dr, Suite C, Bend, OR 97701-3786 | 2009-07-02 |
| 1316161680 | Meredith Rae Baker | Urology | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2007-04-11 |
| 1225064421 | Andrew David Neeb | Urology | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2006-06-23 |
| 1881635779 | Michael T Lavelle Jr. | Urology | 1247 Ne Medical Center Dr, Bend, OR 97701 | 2006-06-09 |
| 1124078738 | William J Corrigan | Urology | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2006-05-12 |
| 1508815754 | Bend Urology Associates, LLC | Urology | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2006-05-07 |
| 1629030523 | Brian Timothy O'hollaren | Urology | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2006-04-05 |
| 1316909773 | Michel Adeodat Boileau | Urology | 2090 Ne Wyatt Ct, Suite 101, Bend, OR 97701-7687 | 2006-04-03 |
| Find all providers in BEND | ||||
Please comment or provide details below to improve the information on DR. JACK ALAN BREWER.
| 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.