Organization
WESTERN NEUROSURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY L HUBBARD MD (OWNER)
(503) 399-1386
Entity
Organization
Contact information
Practice address
875 OAK ST SE, #5060, SALEM, OR 97301
(503) 399-1386
(503) 399-1182
Mailing address
875 OAK ST SE, #5060, SALEM, OR 97301
(503) 399-1386
(503) 399-1182
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD11848
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130294
—
OR
Enumeration date
07/19/2006
Last updated
04/10/2008
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