# SALLY SUZANNE MARIE MD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sally Suzanne Marie MD LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184881393
- **Authorized official:** SALLY SUZANNE MARIE MD (OWNER/PHYSICIAN)
- **Authorized official phone:** (541) 654-4175

## Contact information

- **Practice address:** 1755 COBURG RD STE 5, EUGENE, OR 97401-4982
- **Practice address phone:** (541) 654-4175
- **Mailing address:** 1755 COBURG RD STE 5, EUGENE, OR 97401-4982

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 14482 | OR | Yes |

## Other

- **Enumeration date:** 05/16/2008
- **Last updated:** 11/23/2011