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Organization

SISKIYOU EYE CENTER, MEDICAL GROUP, PC

Active
Other names
Siskiyou Eye Center
Organization subpart
No

Provider details

NPI number
Authorized official
MS. BELMIRA PARDAL BORG (ADMINISTRATOR)
(541) 482-8100
Entity
Organization

Contact information

Practice address
648 N MAIN ST, ASHLAND, OR 97520-1710
(541) 482-8100
(541) 488-5081
Mailing address
648 N MAIN ST, ASHLAND, OR 97520-1710
(541) 482-8100
(541) 488-5081

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
209930-10
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
053574
OR
05
289751
OR
05
298084
OR
Enumeration date
06/09/2005
Last updated
09/27/2007
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