Provider Demographics
NPI:1447345152
Name:MCMINNVILLE EAR NOSE & THROAT
Entity type:Organization
Organization Name:MCMINNVILLE EAR NOSE & THROAT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:TOPPING
Authorized Official - Suffix:IX
Authorized Official - Credentials:MD
Authorized Official - Phone:503-472-7621
Mailing Address - Street 1:2700 SE STRATUS AVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-6258
Mailing Address - Country:US
Mailing Address - Phone:503-472-7621
Mailing Address - Fax:503-434-9761
Practice Address - Street 1:2700 SE STRATUS AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-6258
Practice Address - Country:US
Practice Address - Phone:503-472-7621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD19690174400000X
ORHAS-P-937302231H00000X
OR21518231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR04000935OtherDR TOPPIND RR MEDICARE
OR207501Medicaid
ORP00223552OtherAMY RR MEDICARE
OR1366435240OtherAMYS NPI
OR069067Medicaid
OR240421Medicaid
OR1063406619OtherDR TOPPINGS NPI
OR114664Medicare ID - Type UnspecifiedAMYS MEDICARE
ORP00223552OtherAMY RR MEDICARE
OR1063406619OtherDR TOPPINGS NPI
ORG21422Medicare UPIN