Individual
GARY B. DANDY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2570 NW EDENBOWER BLVD, SUITE 100, ROSEBURG, OR 97470-6220
(541) 957-1111
(541) 957-5705
Mailing address
PO BOX 1247, 2570 NW EDENBOWER BLVD SUITE 100, ROSEBURG, OR 97470-0310
(541) 957-1111
(541) 957-5705
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD16240
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
059969
—
OR
01
—
J406438
INDIVIDUAL PACSOURCE
OR
Enumeration date
02/08/2006
Last updated
07/09/2007
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