Basic Information
| Provider Information | |||||||||
| NPI: | 1548917222 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARNUM | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | CRM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 311 49TH ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974786085 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413596420 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 195 W 12TH AVE | ||||||||
| Address2: | |||||||||
| City: | EUGENE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974013408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417624319 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2022 | ||||||||
| LastUpdateDate: | 03/03/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 175T00000X | OR | Y |
No ID Information.