Organization
ASC GI DIAGNOSTIC CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN B. ARCHER MD (MEDICAL DIRECTOR)
(541) 322-5753
Entity
Organization
Contact information
Practice address
2084 NE PROFESSIONAL CT, BEND, OR 97701-6077
(541) 322-5753
(541) 749-2130
Mailing address
2084 NE PROFESSIONAL CT, BEND, OR 97701-6077
(541) 322-5753
(541) 749-2130
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
071580
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006075
—
OR
Enumeration date
06/30/2006
Last updated
05/24/2011
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