Fawcett, Cory

Fawcett, Cory is an individual health care provider with primary practice located at 1600 Nw 6Th St North Suite, Grants Pass OR 97526-1094. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Fawcett, Cory can be contacted via phone (541) 474-5533.

Contact Information

Primary practice address
1600 Nw 6Th St North Suite Grants Pass OR 97526-1094
Phone: (541) 474-5533
Fax: (541) 476-2380
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD18198 Oregon
Allopathic & Osteopathic Physicians / Surgery 208600000X G68483 California

Profile Details

NPI number 1467455774
LBN Legal business name Fawcett, Cory
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2005
Last updated Feb 20th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467455774 NPPES
Oregon MEDICAID 057047

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