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5234 Philomath Boulevard Corvallis OR 97333-1042 | |
(541) 768-4970 | |
(541) 768-4971 |
Full Name | |
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Speciality | Family Medicine |
Location | 5234 Philomath Boulevard, Corvallis, Oregon |
Authorized Official Name and Position | Joseph M Cahill (CEO-GSRMC) |
Authorized Official Contact | 5417687914 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1189 Corvallis OR 97339-1189 Ph: (541) 768-6768 | 5234 Philomath Boulevard Corvallis OR 97333-1042 Ph: (541) 768-4970 |
NPI Number | 1427323690 |
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Provider Enumeration Date | 03/20/2012 |
Last Update Date | 07/31/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427323690 | NPI | - | NPPES |
500651545 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 14-1074-4 (Oregon) | Primary |
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