| Pmg South Physiatry | |
|
827 Spring St Medford OR 97504-6111 | |
| (541) 732-8360 | |
| (541) 732-8361 |
| Full Name | Pmg South Physiatry |
|---|---|
| Speciality | Clinic/center |
| Location | 827 Spring St, Medford, Oregon |
| Authorized Official Name and Position | Donald W Anderson (DIR REIMB REG STRAT/ASST SEC ENROLL) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pmg South Physiatry Po Box 3158 Portland OR 97208-3158 Ph: (541) 732-8360 | Pmg South Physiatry 827 Spring St Medford OR 97504-6111 Ph: (541) 732-8360 |
| NPI Number | 1699917781 |
|---|---|
| Provider Enumeration Date | 04/03/2009 |
| Last Update Date | 07/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699917781 | NPI | - | NPPES |
| 500613379 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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