Individual
DR. RICHARD C BOUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
613 N 1ST AVE, STAYTON, OR 97383-1704
(503) 769-7771
(503) 769-4630
Mailing address
613 N 1ST AVE, STAYTON, OR 97383-1704
(503) 769-7771
(503) 769-4630
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD10079
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
072678
—
OR
05
—
1114088101
—
OR
Enumeration date
12/13/2006
Last updated
06/12/2020
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