| Dr Robert John Laciak, MD | |
|
990 Nw Circle Blvd, Suite 102, Corvallis, OR 97330-1967 | |
| (541) 768-5486 | |
| Not Available |
| Full Name | Dr Robert John Laciak |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 19 Years |
| Location | 990 Nw Circle Blvd, Corvallis, Oregon |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114196169 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 6851346-1205 (Utah) | Secondary |
| 208800000X | Urology | MD152679 (Oregon) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Good Samaritan Regional Medical Center | Corvallis, OR | Hospital |
| Samaritan Pacific Community Hospital | Newport, OR | Hospital |
| Samaritan Lebanon Community Hospital | Lebanon, OR | Hospital |
| Samaritan Albany General Hospital | Albany, OR | Hospital |
| Samaritan North Lincoln Hospital | Lincoln city, OR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Good Samaritan Hospital Corvallis | 1557270725 | 353 |
| Entity Name | Good Samaritan Hospital Corvallis |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962453134 PECOS PAC ID: 1557270725 Enrollment ID: O20031125000163 |
| Entity Name | Samaritan Pacific Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174888010 PECOS PAC ID: 2466353529 Enrollment ID: O20040204000304 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Robert John Laciak, MD Po Box 1189, Corvallis, OR 97339-1189 Ph: () - | Dr Robert John Laciak, MD 990 Nw Circle Blvd, Suite 102, Corvallis, OR 97330-1967 Ph: (541) 768-5486 |
Ms. Mary Ochadlik, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 444 Nw Elks Dr, Corvallis, OR 97330 Phone: 541-754-1150 | |
Layron O Long, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 990 Nw Circle Blvd, Suite 102, Corvallis, OR 97330 Phone: 541-768-5486 | |
Dr. Kadi-ann Bryan, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 990 Nw Circle Blvd Ste 102, Corvallis, OR 97330 Phone: 541-768-5486 | |
James Jason Crane, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 990 Nw Circle Blvd Ste 102, Corvallis, OR 97330 Phone: 541-768-5486 | |
Michael D Brant, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 990 Nw Circle Blvd Ste 102, Corvallis, OR 97330 Phone: 541-768-5486 |