| Pmg South Jacksonville | |
|
725 N 5th St Suite 101 Jacksonville OR 97530-9873 | |
| (541) 899-8686 | |
| Not Available |
| Full Name | Pmg South Jacksonville |
|---|---|
| Speciality | Clinic/center |
| Location | 725 N 5th St, Jacksonville, Oregon |
| Authorized Official Name and Position | John Jackson (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5417326000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pmg South Jacksonville Po Box 3158 Portland OR 97208-3158 Ph: () - | Pmg South Jacksonville 725 N 5th St Suite 101 Jacksonville OR 97530-9873 Ph: (541) 899-8686 |
| NPI Number | 1134206790 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 04/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134206790 | NPI | - | NPPES |
| CG6801 | Other | OR | RAIL ROAD NUMBER |
| 022823 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Origins Functional Wellness, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 675 N 5th St, Jacksonville, OR 97530 Phone: 432-638-5747 | |
Healthy U Medical Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7208 Highway 238, Jacksonville, OR 97530 Phone: 541-414-3130 |