SOUTHERN OREGON EAR NOSE & THROAT P C NPI 1821274317

NPI Information

NPI: 1821274317
Provider Name: SOUTHERN OREGON EAR NOSE & THROAT P C
Classification: Otolaryngology - 207YS0123X
Entity Type: Organization

Specialization: Facial Plastic Surgery

Address:
555 BLACK OAK DR STE 210
MEDFORD, OR
ZIP 97504
Phone: (541) 734-3540
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SOUTHERN OREGON EAR NOSE & THROAT P C is a facial plastic surgery otolaryngology in Medford, OR. The provider is an otolaryngologist who specializes in facial plastic surgery. SOUTHERN OREGON EAR NOSE & THROAT P C NPI is 1821274317. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

555 BLACK OAK DR STE 210
MEDFORD, OR
ZIP 97504-491
Phone: (541) 734-3540

The provider's authorized official is Cindi S Boucher .
The authorized official title is Office Manager and has the following contact phone number (541) 734-3610.

The enumeration date for this NPI number is 1/14/2008 and was last updated on 3/10/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207YS0123X	Otolaryngology	Facial Plastic Surgery	MD17390	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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