| Pmg South Pulmonology | |
|
827 Spring St Medford OR 97504-6104 | |
| (541) 732-7600 | |
| (541) 732-7601 |
| Full Name | Pmg South Pulmonology |
|---|---|
| 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 Pulmonology Po Box 3158 Portland OR 97208-3158 Ph: (541) 732-7960 | Pmg South Pulmonology 827 Spring St Medford OR 97504-6104 Ph: (541) 732-7600 |
| NPI Number | 1437469087 |
|---|---|
| Provider Enumeration Date | 10/18/2010 |
| Last Update Date | 07/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437469087 | NPI | - | NPPES |
| 500628691 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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