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905 Main St Ste 211 Klamath Falls OR 97601-6066 | |
(877) 822-4323 | |
(877) 244-2835 |
Full Name | |
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Speciality | Family Medicine |
Location | 905 Main St Ste 211, Klamath Falls, Oregon |
Authorized Official Name and Position | Fiji Simmons (CEO OWNER) |
Authorized Official Contact | 3234557247 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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905 Main St Ste 211 Klamath Falls OR 97601-6066 Ph: (778) 224-3238 | 905 Main St Ste 211 Klamath Falls OR 97601-6066 Ph: (877) 822-4323 |
NPI Number | 1427627751 |
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Provider Enumeration Date | 06/21/2021 |
Last Update Date | 12/20/2024 |
Medicare PECOS PAC ID | 6406253780 |
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Medicare Enrollment ID | O20210929002125 |
Identifier | Type | State | Issuer |
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1427627751 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Fiji Simmons |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124659685 PECOS PAC ID: 6608275631 Enrollment ID: I20210525001766 |
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