Dr Speros Demetre Homer Iii, MD | |
10150 Se 32nd Ave, Milwaukie, OR 97222-6516 | |
(503) 297-6334 | |
(503) 297-2360 |
Full Name | Dr Speros Demetre Homer Iii |
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Gender | Male |
Speciality | Emergency Medicine |
Location | 10150 Se 32nd Ave, Milwaukie, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376631408 | NPI | - | NPPES |
930066589 | Other | OR | UNITED HEALTHCARE |
164982 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | MD19692 (Oregon) | Primary |
Entity Name | Providence Health & Services Oregon |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366536963 PECOS PAC ID: 6103728753 Enrollment ID: O20040123000371 |
Mailing Address | Practice Location Address |
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Dr Speros Demetre Homer Iii, MD 9340 Sw Barnes Rd, Suite 202, Portland, OR 97225-6623 Ph: (503) 297-6334 | Dr Speros Demetre Homer Iii, MD 10150 Se 32nd Ave, Milwaukie, OR 97222-6516 Ph: (503) 297-6334 |
Dr. James Edward Maras, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 10150 Se 32nd Ave, Milwaukie, OR 97222 Phone: 503-297-6334 Fax: 503-297-2360 | |
Dr. Mark N. Roberts, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 10150 Se 32nd Ave, Milwaukie, OR 97222 Phone: 503-297-6334 Fax: 503-297-2360 | |
Dr. Paul Vincent Skiles, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 10150 Se 32nd Ave, Milwaukie, OR 97222 Phone: 503-297-6334 Fax: 503-297-2360 | |
Dr. Jason Dean Sundseth, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 10330 Se 32nd Ave, Milwaukie, OR 97222 Phone: 503-513-8311 | |
Dr. David Glen Knox, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 10150 Se 32nd Ave, Milwaukie, OR 97222 Phone: 503-297-6334 Fax: 503-297-2360 | |
Dr. Preston Joseph Fedor, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 10150 Se 32nd Ave, Milwaukie, OR 97222 Phone: 503-513-8300 |