Carl C Balog (NPI# 1447287636, PAC ID# 9638162167) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERVENTIONAL PAIN MANAGEMENT.
| Nation Provider ID (NPI) | 1447287636 |
| PAC ID by PECOS | 9638162167 |
| Professional Enrollment ID | I20040408000265 |
| Full Name | Carl C Balog |
| Organization Legal Name | PORTLAND PAIN AND SPINE LLC |
| Address |
9370 Sw Greenburg Rd Suite 602 Tigard OR 97223-5429 |
| Phone Number | 5032387246 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1988 |
| Primary Specialty | INTERVENTIONAL PAIN MANAGEMENT |
| Secondary Specialties | PAIN MANAGEMENT |
| Group Practice PAC ID | 7517114556 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380004 | PROVIDENCE ST VINCENT MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 9370 Sw Greenburg Rd, Suite 602, Tigard, OR 97223-5429 | 5032387246 | PORTLAND PAIN AND SPINE LLC |
| Organization Legal Name | PORTLAND PAIN AND SPINE LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joseph E Knaus | Nurse Practitioner | Portland Pain and Spine LLC | 9370 Sw Greenburg Rd, Suite 602, Tigard, OR 97223-5429 |
| Street Address |
9370 SW GREENBURG RD SUITE 602 |
| City | TIGARD |
| State | OR |
| Zip | 97223-5429 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dennis M Cozzocrea | Chiropractic | 9370 Sw Greenburg Rd, Suite N, Portland, OR 97223-5408 | |
| Tyler Belnap | Podiatry | Portland Foot and Ankle, LLC | 9370 Sw Greenburg Rd, Suite 102, Portland, OR 97223-5428 |
| Stephen M Hayes | Podiatry | Portland Foot and Ankle, LLC | 9370 Sw Greenburg Rd, Suite 102, Portland, OR 97223-5428 |
| Joseph E Knaus | Nurse Practitioner | Portland Pain and Spine LLC | 9370 Sw Greenburg Rd, Suite 602, Tigard, OR 97223-5429 |
| W Michael Ryan | Internal Medicine | 9370 Sw Greenburg Rd, Portland, OR 97223-5429 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Quincy Michael Shorthill | Physical Therapy | 8915 Swnordic Dr, Tigard, OR 97223 | |
| Robert L Marrs | Clinical Social Worker | 7175 Sw Beveland St, Suite 200, Tigard, OR 97223 | |
| Halsy J Carter | Chiropractic | 12700 Sw N Dakota St, 180 Straight Up Chiropractic, Tigard, OR 97223-0802 | |
| Heidi U Ferguson | Family Medicine | Providence Health and Services Oregon | 12442 Sw Scholls Ferry Rd, Suite 100, Tigard, OR 97223-0803 |
| Evagelia Baros | Internal Medicine | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Yvonne Howell | Physician Assistant | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Raghuveer B Shenoy | Internal Medicine | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Kathryn Marie Lund | Nurse Practitioner | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Kevin A Brooks | Physician Assistant | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Kirsten A Holmes | Physician Assistant | Providence Health and Services Oregon | 12442 Sw Scholls Ferry, Rd Suite 106, Tigard, OR 97223-0803 |
| Find all physicians in zip 97223 | |||
| City | TIGARD |
| Zip Code | 97223 |
| Specialty | INTERVENTIONAL PAIN MANAGEMENT |
| City + Specialty | TIGARD + INTERVENTIONAL PAIN MANAGEMENT |
Please comment or provide details below to improve the information on Carl C Balog.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.