Provider Demographics
NPI:1972692861
Name:OAKES, DENNIS EUGENE (PA-C)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:EUGENE
Last Name:OAKES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 SISTER MARY COLUMBA DR
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-4356
Mailing Address - Country:US
Mailing Address - Phone:530-347-3418
Mailing Address - Fax:
Practice Address - Street 1:20833 LONG BRANCH DR
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:CA
Practice Address - Zip Code:96022-8701
Practice Address - Country:US
Practice Address - Phone:530-347-3418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA01947363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA01947OtherTX LICENSE NUMBER
TXPA01947OtherTX LICENSE NUMBER
TX8G1719Medicare PIN
TX8N9352Medicare PIN