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Glenn M Koteen M.d., Llc
Medical Specialty Clinic/Center in Bend, Oregon
NPI 1407021348

Glenn M Koteen M.d., Llc is a Medical Specialty Clinic/Center based in Bend, OR and is specialized in Medical Specialty. Glenn M Koteen M.d., Llc practices in Bend, OR. The NPI Number for Glenn M Koteen M.d., Llc is 1407021348 and holds a License No. MD25338 (Oregon).

The current practice location address for Glenn M Koteen M.d., Llc is 2450 Ne Mary Rose Pl, Bend, OR and can be reached out via phone at 541-728-0535 and via fax at 541-647-5125.

Location: 2450 Ne Mary Rose Pl, Bend, OR, 97701-7132
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1407021348
Provider Name
Glenn M Koteen M.d., Llc
Credential
Provider Entity Type
Organization
Address
2450 Ne Mary Rose Pl, Bend, OR, 97701-7132
Phone Number
541-728-0535
Fax Number
541-647-5125
Provider Enumeration Date
04/22/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
120175 01 OR MEDICARE #
022737 05 OR
institution
Provider Business Practice Location Address Details
Address
2450 Ne Mary Rose Pl
City
Bend
State
Oregon
Zip
97701-7132
Phone Number
541-728-0535
Fax Number
541-647-5125
person
Provider Business Mailing Address Details
Address
2450 Ne Mary Rose Pl
City
Bend
State
Oregon
Zip
97701-7132
Phone Number
541-728-0535
Fax Number
541-647-5125
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
MD25338 (Oregon)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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