Organization
SOUTH COAST ORTHOPAEDIC ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER T CLARKE (CLINIC ADMINISTRATOR)
(541) 266-3600
Entity
Organization
Contact information
Practice address
2699 N 17TH ST, COOS BAY, OR 97420-2134
(541) 266-3600
(541) 269-0708
Mailing address
2699 N 17TH ST, COOS BAY, OR 97420-2134
(541) 266-3600
(541) 269-0708
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
OR
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
076799
—
OR
Enumeration date
05/20/2006
Last updated
12/10/2010
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