Individual
HEIDI TAYLOR BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2780 E BARNETT RD STE 200, MEDFORD, OR 97504-8674
(541) 779-6250
(541) 608-2535
Mailing address
2780 E BARNETT RD STE 200, MEDFORD, OR 97504-8674
(541) 779-6250
(541) 608-2535
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
MD24000
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286646
—
OR
Enumeration date
10/12/2005
Last updated
10/05/2022
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