Organization
BEND MEMORIAL CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY HAGFORS (CEO)
(541) 706-5401
Entity
Organization
Contact information
Practice address
865 SW VETERANS WAY, REDMOND, OR 97756-2563
(541) 322-3500
Mailing address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-2811
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207K00000X
Allergy & Immunology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RN0300X
Nephrology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207RX0202X
Medical Oncology Physician
—
—
207W00000X
Ophthalmology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213243
—
OR
Enumeration date
03/25/2010
Last updated
01/31/2012
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