Pmg South Medford Family Practice
LBN: Providence Health & Services Oregon
Pmg South Medford Family Practice is an health care organization with primary practice located at 1698 E Mcandrews Rd Suite 300, Medford OR 97504-5589. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Providence Health & Services Oregon can be contacted via phone (541) 732-7950, or through Anderson, Donald Wayne via phone (425) 525-5392.
Contact Information
Primary practice address
1698 E Mcandrews Rd Suite 300
Medford OR 97504-5589
Phone: (541) 732-7950
Fax: (541) 732-7901
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X |
Profile Details
| NPI number | 1386713972 |
|---|---|
| LBN Legal business name | Providence Health & Services Oregon |
| DBA Doing business as | Pmg South Medford Family Practice |
| Authorized official | Anderson, Donald Wayne |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 7th, 2006 |
| Last updated | Apr 24th, 2019 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386713972 | NPPES |
| Oregon | MEDICAID | 288499 | |
| Oregon | Other | CG6801 |
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