Gentry, Robert Mark

Gentry, Robert Mark is an individual health care provider with primary practice located at 1585 Nw Washington Blvd , Grants Pass OR 97526-1049. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gentry, Robert Mark can be contacted via phone (541) 474-5511.

Contact Information

Primary practice address
1585 Nw Washington Blvd Grants Pass OR 97526-1049
Phone: (541) 474-5511
Fax: (541) 474-1662
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD11487 Oregon

Profile Details

NPI number 1255338471
LBN Legal business name Gentry, Robert Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2005
Last updated Jul 1st, 2010 - about 15 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 1255338471 NPPES
Oregon MEDICAID 043364
Oregon Other 080085678

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