Bandon Family Medicine, Llc | |
475 Elmira Ave Se Ste 201 Bandon OR 97411-7409 | |
(541) 329-1362 | |
(541) 329-1364 |
Full Name | Bandon Family Medicine, Llc |
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Speciality | Family Medicine |
Location | 475 Elmira Ave Se Ste 201, Bandon, Oregon |
Authorized Official Name and Position | Megan Marie Holland (SOLE MEMBER) |
Authorized Official Contact | 5413291362 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Bandon Family Medicine, Llc 475 Elmira Ave Se Ste 201 Bandon OR 97411-7409 Ph: (541) 329-1362 | Bandon Family Medicine, Llc 475 Elmira Ave Se Ste 201 Bandon OR 97411-7409 Ph: (541) 329-1362 |
NPI Number | 1124215736 |
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Provider Enumeration Date | 09/27/2007 |
Last Update Date | 07/09/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124215736 | NPI | - | NPPES |
244093 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | MD27591 (Oregon) | Primary |
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Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 475 Elmira Ave Se, Suite 103, Bandon, OR 97411 Phone: 541-347-2111 Fax: 541-347-1212 |