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Organization
STARK MEDICAL, PC
Active
Organization
STARK MEDICAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA L STARK BS/BM (OFFICE ADMINISTRATOR)
(541) 889-2244
Entity
Organization
Contact information
Practice address
932 W IDAHO AVE STE 100, ONTARIO, OR 97914-2155
(541) 889-2244
(541) 889-2626
Mailing address
PO BOX J, ONTARIO, OR 97914-0020
(541) 889-2244
(541) 889-2626
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
NULL
207K00000X
Allergy & Immunology Physician
—
—
207KA0200X
Allergy Physician
—
NULL
207KA0200X
Allergy Physician
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207RI0200X
Infectious Disease Physician
—
NULL
207RI0200X
Infectious Disease Physician
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
06/10/2008
Last updated
06/10/2008
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