Organization
DOUGLAS MEDICAL CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDA L TYLER (CLINIC ADMINISTRATOR)
(541) 440-6390
Entity
Organization
Contact information
Practice address
1813 W HARVARD AVE, SUITE 201, ROSEBURG, OR 97470-2752
(541) 440-6390
(541) 440-6392
Mailing address
1813 W HARVARD AVE, SUITE 201, ROSEBURG, OR 97470-2752
(541) 440-6390
(541) 440-6392
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288040
—
OR
Enumeration date
12/13/2006
Last updated
09/11/2025
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