Sally Suzanne Marie Md Llc | |
1755 Coburg Rd Ste 5 Eugene OR 97401-4982 | |
(541) 654-4175 | |
Not Available |
Full Name | Sally Suzanne Marie Md Llc |
---|---|
Speciality | Family Medicine |
Location | 1755 Coburg Rd Ste 5, Eugene, Oregon |
Authorized Official Name and Position | Sally Suzanne Marie (OWNER/PHYSICIAN) |
Authorized Official Contact | 5416544175 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Sally Suzanne Marie Md Llc 1755 Coburg Rd Ste 5 Eugene OR 97401-4982 Ph: () - | Sally Suzanne Marie Md Llc 1755 Coburg Rd Ste 5 Eugene OR 97401-4982 Ph: (541) 654-4175 |
NPI Number | 1184881393 |
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Provider Enumeration Date | 05/16/2008 |
Last Update Date | 11/23/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184881393 | NPI | - | NPPES |
142976 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 14482 (Oregon) | Primary |
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