Organization
ICCO LLC
Active
Other names
Five Rivers Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS BAILEY M.D. (MEDICAL DIRECTOR - PRIMARY CARE)
(541) 782-4068
Entity
Organization
Contact information
Practice address
48134 HWY 58, OAKRIDGE, OR 97463
(541) 782-4068
(541) 782-4113
Mailing address
1292 HIGH STREET, SUITE 224, EUGENE, OR 97401
(541) 228-3865
(541) 654-4693
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
8928878
OR
Other
Enumeration date
12/19/2006
Last updated
07/16/2019
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