Provider Demographics
NPI:1124187000
Name:MCPARTLAND, BRIAN (OD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:MCPARTLAND
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 ADMIRAL CIRCLE
Mailing Address - Street 2:
Mailing Address - City:MERLIN
Mailing Address - State:OR
Mailing Address - Zip Code:97532-8742
Mailing Address - Country:US
Mailing Address - Phone:541-472-9361
Mailing Address - Fax:
Practice Address - Street 1:200 ADMIRAL CIR
Practice Address - Street 2:
Practice Address - City:MERLIN
Practice Address - State:OR
Practice Address - Zip Code:97532-8742
Practice Address - Country:US
Practice Address - Phone:541-472-9361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7797T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR3204ATOtherOREGON STATE LICENSE (ACTIVE)
CA7797TOtherCALIFORNIA STATE LICENSE (INACTIVE)
CASD0077970Medicaid
CASD0077970Medicaid
OR3204ATOtherOREGON STATE LICENSE (ACTIVE)