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Organization
NICOLA J CHERRY MD LLC
Active
Organization
NICOLA J CHERRY MD LLC
Active
Other names
The Childrens Clinic of Klamath
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLA J CHERRY M.D. (OWNER)
(541) 884-1224
Entity
Organization
Contact information
Practice address
2580 DAGGETT AVE, KLAMATH FALLS, OR 97601-1127
(541) 884-1224
Mailing address
PO BOX 1359, KLAMATH FALLS, OR 97601-0075
(541) 882-1540
(541) 882-2583
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD21778
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288475
—
OR
Enumeration date
07/07/2006
Last updated
08/21/2009
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