| Gordon F. Rose, Pc | |
|
544 W Umpqua St Ste 104 Roseburg OR 97470-2999 | |
| (541) 673-3334 | |
| (541) 673-0814 |
| Full Name | Gordon F. Rose, Pc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 544 W Umpqua St Ste 104, Roseburg, Oregon |
| Authorized Official Name and Position | Gordon Frederik Rose (PRESIDENT) |
| Authorized Official Contact | 5416733334 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gordon F. Rose, Pc 544 W Umpqua St Ste 104 Roseburg OR 97470-2999 Ph: (541) 673-3334 | Gordon F. Rose, Pc 544 W Umpqua St Ste 104 Roseburg OR 97470-2999 Ph: (541) 673-3334 |
| NPI Number | 1063611465 |
|---|---|
| Provider Enumeration Date | 07/16/2007 |
| Last Update Date | 02/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063611465 | NPI | - | NPPES |
| 004395 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MD15903 (Oregon) | Primary |
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