Organization
SALLY SUZANNE MARIE MD
Active
Other names
Sally Suzanne Marie MD LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SALLY SUZANNE MARIE MD (OWNER/PHYSICIAN)
(541) 654-4175
Entity
Organization
Contact information
Practice address
1755 COBURG RD STE 5, EUGENE, OR 97401-4982
(541) 654-4175
Mailing address
1755 COBURG RD STE 5, EUGENE, OR 97401-4982
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14482
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142976
—
OR
Enumeration date
05/16/2008
Last updated
11/23/2011
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