# CARDIOVASCULAR INSTITUTE OF SOUTHERN OREGON, LLC

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

## Provider details

- **NPI number:** 1134158983
- **Authorized official:** DR. STEPHEN J SCHNUGG MD (PRESIDENT - BOARD OF DIRECTORS)
- **Authorized official phone:** (541) 282-6660

## Contact information

- **Practice address:** 520 MEDICAL CENTER DR, SUITE 150, MEDFORD, OR 97504-4334
- **Practice address phone:** (541) 282-6660
- **Practice address fax:** (541) 282-6661
- **Mailing address:** 520 MEDICAL CENTER DR, SUITE 150, MEDFORD, OR 97504-4334
- **Mailing address phone:** (541) 282-6660
- **Mailing address fax:** (541) 282-6661

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/02/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 247301 | — | OR |