Providence Health & Services Oregon
May also be knows as Pmg South General Surgery
Clinic/Center in Medford, OR(View on Map)
Legal Business Name
Providence Health & Services Oregon
Also Known As
Pmg South General Surgery
NPI Number
1093894511
NPI Type
Organization
Enumeration Date
11/03/2006
Specialties
(Taxonomies)Contact
Information
Purpose
Mailing
Location
Address
PO BOX 3158
1698 E MCANDREWS RD
City
Portland
Medford
State
OR
OR
Postal Code
97208-3158
97504-5589
Country
US
US
Telephone Number
(503) 215-6494
(541) 732-7874
Authorized Official
Name
John Jackson
Title or Position
CHIEF EXECUTIVE OFFICER
Telephone Number
(541) 732-6000
Identifiers
Identifier
022869
CG6801
Identifier State
OR
OR
Identifier Issuer
Unknown
RAIL ROAD MEDIARE
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 05/12/2023
Provider Address
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