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Organization

JAY N. GADE, MD, PHD, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAY N GADE M.D., PHD (OWNER)
(541) 957-1141
Entity
Organization

Contact information

Practice address
2579 NW EDENBOWER BLVD, ROSEBURG, OR 97470-6220
(541) 957-1141
(541) 957-1466
Mailing address
2579 NW EDENBOWER BLVD, ROSEBURG, OR 97470-6220
(541) 957-1141
(541) 957-1466

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD20360
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
150092
OR
Enumeration date
10/15/2007
Last updated
10/15/2007
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