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Organization
RETINA CARE CENTER, LLC
Active
Organization
RETINA CARE CENTER, LLC
Active
Other names
Retina Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM C AUFDERHEIDE MD (MEMBER)
(541) 842-2020
Entity
Organization
Contact information
Practice address
748 STATE ST, MEDFORD, OR 97504-8473
(541) 842-2020
(541) 842-2022
Mailing address
748 STATE ST, MEDFORD, OR 97504-8473
(541) 842-2020
(541) 842-2022
Taxonomy
Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
—
NULL
152WV0400X
Vision Therapy Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286236
—
OR
01
—
CK6077
MEDICARE RAILROAD
OR
Enumeration date
03/27/2006
Last updated
08/14/2023
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