Organization
OAK STREET HEALTH CARE CENTER P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE M WILSON (ADMINISTRATOR)
(541) 469-6023
Entity
Organization
Contact information
Practice address
446 OAK ST, BROOKINGS, OR 97415-9612
(541) 412-8898
(541) 412-7420
Mailing address
PO BOX 6579, BROOKINGS, OR 97415-0285
(541) 412-8898
(541) 412-7420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
228756
—
OR
Enumeration date
06/03/2006
Last updated
01/22/2010
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