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Organization
VISTA PATHOLOGY, PC
Active
Organization
VISTA PATHOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS R TREGER M.D. (OWNER)
(541) 789-4897
Entity
Organization
Contact information
Practice address
94220 4TH ST, GOLD BEACH, OR 97444-7756
(800) 445-8085
Mailing address
PO BOX 1470, PHOENIX, OR 97535-1470
(541) 789-4897
(541) 789-5942
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292293
—
OR
Enumeration date
06/07/2011
Last updated
06/07/2011
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