# ONEPEAK SOUTHERN OREGON PC

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

## Provider details

- **NPI number:** 1740917558
- **Authorized official:** KARISSA STULTS (DIRECTOR OF BILLING)
- **Authorized official phone:** (541) 890-5217

## Contact information

- **Practice address:** 3265 HILLCREST PARK DR, MEDFORD, OR 97504-7657
- **Practice address phone:** (541) 890-5217
- **Mailing address:** 3265 HILLCREST PARK DR, MEDFORD, OR 97504-7657
- **Mailing address phone:** (541) 890-5217

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/02/2022
- **Last updated:** 08/02/2022