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Individual

TIMOTHY MACCURDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
3156 STATE ST, MEDFORD, OR 97504-8450
(541) 773-9772
(541) 773-1113
Mailing address
815 N CENTRAL AVE, STE C, MEDFORD, OR 97501-5873
(541) 734-9030
(541) 734-9885

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
PA163288
OR
363A00000X
Physician Assistant
PA10004497
WA
363A00000X
Physician Assistant
Primary
PA163288
OR

Other

Enumeration date
01/18/2007
Last updated
04/18/2018
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