Wild Rose Medical Clinic Pc | |
401 E 10th Ave Suite 250 Eugene OR 97401-3317 | |
(541) 686-4153 | |
(541) 686-3468 |
Full Name | Wild Rose Medical Clinic Pc |
---|---|
Speciality | Family Medicine |
Location | 401 E 10th Ave, Eugene, Oregon |
Authorized Official Name and Position | Kathleen Cordes (PRESIDENT) |
Authorized Official Contact | 5416864153 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Wild Rose Medical Clinic Pc 401 E 10th Ave Suite 250 Eugene OR 97401-3317 Ph: (541) 686-4153 | Wild Rose Medical Clinic Pc 401 E 10th Ave Suite 250 Eugene OR 97401-3317 Ph: (541) 686-4153 |
NPI Number | 1083762637 |
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Provider Enumeration Date | 01/08/2007 |
Last Update Date | 10/10/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083762637 | NPI | - | NPPES |
072173 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 16009 (Oregon) | Primary |
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