Individual
CARL RUSSELL GRIESSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2828 E BARNETT RD, MEDFORD, OR 97504-8342
(541) 789-8000
(541) 789-8225
Mailing address
2825 E BARNETT RD, MSS, MEDFORD, OR 97504-8332
(541) 789-4281
(541) 789-4806
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD155331
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
067665
OMAP
OR
05
—
227698
—
OR
05
—
500642273
—
OR
Enumeration date
11/21/2011
Last updated
12/19/2023
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