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Organization

PHYSICIANS MEDICAL GROUP, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. VICKIE STEPHENS (OFFICE MANAGER)
(541) 474-1020
Entity
Organization

Contact information

Practice address
1619 NW HAWTHORNE AVE STE 201, GRANTS PASS, OR 97526-6009
(541) 474-1020
Mailing address
1619 NW HAWTHORNE AVE STE 201, GRANTS PASS, OR 97526-6009
(541) 474-1020

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
207RP1001X
Pulmonary Disease Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
286799
OR
Enumeration date
08/30/2006
Last updated
01/28/2011
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