Organization
GORDON F. ROSE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORDON FREDERIK ROSE MD (PRESIDENT)
(541) 673-3334
Entity
Organization
Contact information
Practice address
544 W UMPQUA ST STE 104, ROSEBURG, OR 97470-2999
(541) 673-3334
(541) 673-0814
Mailing address
544 W UMPQUA ST STE 104, ROSEBURG, OR 97470-2999
(541) 673-3334
(541) 673-0814
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD15903
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004395
—
OR
Enumeration date
07/16/2007
Last updated
02/01/2008
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