| M. Lee Gardner Md, Llc | |
|
10245 Nw Glencoe Rd North Plains OR 97133-8233 | |
| (503) 647-9261 | |
| (503) 647-1230 |
| Full Name | M. Lee Gardner Md, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 10245 Nw Glencoe Rd, North Plains, Oregon |
| Authorized Official Name and Position | Marion Lee Gardner (OWNER) |
| Authorized Official Contact | 5036479261 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| M. Lee Gardner Md, Llc 10245 Nw Glencoe Rd North Plains OR 97133-8233 Ph: (503) 647-9261 | M. Lee Gardner Md, Llc 10245 Nw Glencoe Rd North Plains OR 97133-8233 Ph: (503) 647-9261 |
| NPI Number | 1982880761 |
|---|---|
| Provider Enumeration Date | 01/11/2008 |
| Last Update Date | 01/10/2013 |
| Medicare PECOS PAC ID | 6103720958 |
|---|---|
| Medicare Enrollment ID | O20031122000085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982880761 | NPI | - | NPPES |
| 044292 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
| Provider Name | Marion L Gardner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740382480 PECOS PAC ID: 7911801766 Enrollment ID: I20031122000116 |
Tuality Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10395 Nw Glencoe Rd Ste 200, North Plains, OR 97133 Phone: 503-647-9400 Fax: 503-647-5120 | |
Michelle L. Mears, Md , P.c Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10395 Nw Glencoe Rd, Suite 200, North Plains, OR 97133 Phone: 503-647-9400 Fax: 503-647-5120 | |
Tuality Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10245 Nw Glencoe Rd, North Plains, OR 97133 Phone: 503-647-9261 Fax: 503-647-1230 |