Individual
DR. PHILLIP C. HISTAND
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1700 GEARY ST SE, ALBANY, OR 97322-6842
(541) 812-5500
(541) 812-5505
Mailing address
1700 GEARY ST SE, ALBANY, OR 97322-6842
(541) 812-5500
(541) 812-5505
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD16275
OR
Other
Enumeration date
06/12/2006
Last updated
07/08/2007
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