# OREGON SURGICAL SPECIALISTS PC

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

## Provider details

- **NPI number:** 1427139732
- **Authorized official:** DR. DAVID L STREET M.D. (PRESIDENT OF CORPORATION)
- **Authorized official phone:** (541) 930-8907

## Contact information

- **Practice address:** 520 MEDICAL CENTER DR, STE 300, MEDFORD, OR 97504-4316
- **Practice address phone:** (541) 930-8907
- **Practice address fax:** (541) 282-6710
- **Mailing address:** 520 MEDICAL CENTER DR, STE 300, MEDFORD, OR 97504-4316
- **Mailing address phone:** (541) 930-8907
- **Mailing address fax:** (541) 282-6710

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/17/2006
- **Last updated:** 07/12/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 004898000 | BLUE CROSS | OR |
| 05 | — | 081653 | — | OR |