Organization

Southern Oregon Foot & Ankle, Llc

Foot Surgery Podiatrist in Medford, OR(View on Map)

Legal Business Name

Southern Oregon Foot & Ankle, Llc

NPI Number

1891980546

NPI Type

Organization

Enumeration Date

09/06/2007

Specialties

(Taxonomies)

Code

213ES0131X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

1904 E BARNETT RD
1904 E BARNETT RD

City

Medford
Medford

State

OR
OR

Postal Code

97504-8262
97504-8262

Country

US
US

Telephone Number

(541) 776-3338
(541) 776-3338

Authorized Official

Name

Evan Merrill

Title or Position

OWNER

Telephone Number

(541) 776-3338

Identifiers

Identifier

243148
891269000

Identifier State

OR
OR

Identifier Issuer

Unknown
BLUE CROSS GROUP #

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 09/16/2020

Provider Address