Organization
ROSEBURG CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DELL G GRAY MA (CEO)
(541) 673-8988
Entity
Organization
Contact information
Practice address
2750 W HARVARD AVE, ROSEBURG, OR 97471-2608
(541) 673-8988
(541) 672-8103
Mailing address
2750 W HARVARD AVE, ROSEBURG, OR 97471-2608
(541) 673-8988
(541) 672-8103
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136247
—
OR
Enumeration date
12/19/2005
Last updated
10/10/2008
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