Mark M Herscher Do | |
145 Ne Broadway Myrtle Creek OR 97457-0117 | |
(541) 863-3146 | |
(541) 863-3226 |
Full Name | Mark M Herscher Do |
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Speciality | Family Medicine |
Location | 145 Ne Broadway, Myrtle Creek, Oregon |
Authorized Official Name and Position | Cheryl Diane Herscher (OFFICE MANAGER) |
Authorized Official Contact | 5418633146 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Mark M Herscher Do Po Box 789 Myrtle Creek OR 97457-0117 Ph: (541) 863-3146 | Mark M Herscher Do 145 Ne Broadway Myrtle Creek OR 97457-0117 Ph: (541) 863-3146 |
NPI Number | 1316125784 |
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Provider Enumeration Date | 02/07/2008 |
Last Update Date | 04/07/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316125784 | NPI | - | NPPES |
138784 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | DO14354 (Oregon) | Primary |
Evergreen Family Medicine South Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 145 Ne Broadway St, Myrtle Creek, OR 97457 Phone: 541-863-3146 Fax: 541-863-3226 |