Individual
DR. KENNETH ROBERT AMPEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1698 E MCANDREWS RD, #400, MEDFORD, OR 97504-5589
(541) 732-6000
Mailing address
1014 BLACK OAK DR., MEDFORD, OR 97504
(541) 779-3859
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD10107
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD10107
OR MEDICAL LICENSE
OR
Enumeration date
09/11/2006
Last updated
10/01/2007
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