Pmg South General Surgery

LBN: Providence Health & Services Oregon
Pmg South General Surgery is an health care organization with primary practice located at 1698 E Mcandrews Rd Suite 160, Medford OR 97504-5589. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Providence Health & Services Oregon can be contacted via phone (541) 732-7874, or through Jackson, John W via phone (541) 732-6000.

Contact Information

Primary practice address
1698 E Mcandrews Rd Suite 160 Medford OR 97504-5589
Phone: (541) 732-7874
Fax: (541) 732-7875
Website:
Map and Directions
Authorized official contact:
Name: Jackson, John W Doctor of Medicine (MD)
Phone: (541) 732-6000

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1093894511
LBN Legal business name Providence Health & Services Oregon
DBA Doing business as Pmg South General Surgery
Authorized official Jackson, John W Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 3rd, 2006
Last updated May 12th, 2023 - about 2 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 1093894511 NPPES
Oregon MEDICAID 022869
Oregon Other CG6801

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