Dba Roseburg Urology

LBN: Centennial Medical Group, Inc
Dba Roseburg Urology is an health care organization with primary practice located at 2460 Nw Stewart Parkway, Suite 100, Roseburg OR 97471. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as the primary health care specialty. Centennial Medical Group, Inc can be contacted via phone (541) 677-6141, or through Gray, Jason via phone (541) 677-2494.

Contact Information

Primary practice address
2460 Nw Stewart Parkway, Suite 100 Roseburg OR 97471
Phone: (541) 677-6141
Fax: (541) 677-6143
Website:
Map and Directions
Authorized official contact:
Name: Gray, Jason Doctor of Medicine (MD)
Phone: (541) 677-2494

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 497634-93 Oregon

Profile Details

NPI number 1225207152
LBN Legal business name Centennial Medical Group, Inc
DBA Doing business as Dba Roseburg Urology
Authorized official Gray, Jason Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 25th, 2008
Last updated Apr 4th, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225207152 NPPES
Oregon MEDICAID 171678

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