Provider Demographics
NPI:1538332291
Name:JAMES T PAPPAS, MD, PC
Entity Type:Organization
Organization Name:JAMES T PAPPAS, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:PAPPAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-231-3355
Mailing Address - Street 1:5050 NE HOYT ST STE 428
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-2984
Mailing Address - Country:US
Mailing Address - Phone:503-231-3355
Mailing Address - Fax:503-231-3370
Practice Address - Street 1:5050 NE HOYT ST STE 428
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2984
Practice Address - Country:US
Practice Address - Phone:503-231-3355
Practice Address - Fax:503-231-3370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500605809Medicaid
ORR0000BBBWKMedicare PIN
OR500605809Medicaid