# ROSEBURG CLINIC PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023094307
- **Authorized official:** DELL G GRAY MA (CEO)
- **Authorized official phone:** (541) 673-8988

## Contact information

- **Practice address:** 2750 W HARVARD AVE, ROSEBURG, OR 97471-2608
- **Practice address phone:** (541) 673-8988
- **Practice address fax:** (541) 672-8103
- **Mailing address:** 2750 W HARVARD AVE, ROSEBURG, OR 97471-2608
- **Mailing address phone:** (541) 673-8988
- **Mailing address fax:** (541) 672-8103

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/19/2005
- **Last updated:** 10/10/2008