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MEDFORD MEDICAL CLINIC LLP NPI 1366449662


NPI Information

NPI: 1366449662
Provider Name: MEDFORD MEDICAL CLINIC, LLP
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
555 BLACK OAK DR
SUITE 100
MEDFORD, OR
ZIP 97504
Phone: (541) 734-3430
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MEDFORD MEDICAL CLINIC, LLP is a family medicine in Medford, OR. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MEDFORD MEDICAL CLINIC, LLP NPI is 1366449662. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

555 BLACK OAK DR
SUITE 100
MEDFORD, OR
ZIP 97504-447
Phone: (541) 734-3430
Fax: (541) 734-3666

The provider's authorized official is Jon Kane Vanvalkenburg .
The authorized official title is Partner and has the following contact phone number (541) 734-3430.

The enumeration date for this NPI number is 6/30/2005 and was last updated on 5/6/2014.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineOREGONNo
2363L00000XNurse PractitionerOREGONNo
3207R00000XInternal MedicineOREGONNo
4207Q00000XFamily MedicineMD21703OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1G46004MEDICARE UPINOREGON
24889450001MEDICARE NSCOREGON

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.