Organization
UROLOGY ASSOCIATES OF SOUTHERN OREGON, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY JEAN FADLING MBA (OFFICE MANAGER)
(541) 772-6600
Entity
Organization
Contact information
Practice address
2900 DOCTORS PARK DR, SUITE 100, MEDFORD, OR 97504-8198
(541) 772-6600
(541) 779-1266
Mailing address
2900 DOCTORS PARK DRIVE, SUITE 100, MEDFORD, OR 97504-6111
(541) 772-6600
(541) 779-1266
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001930000
BLUE CROSS BLUE SHIELD ID
OR
05
—
292844
—
OR
Enumeration date
09/14/2006
Last updated
07/21/2022
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