Individual
JOE WANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
150 NE KENNETH FORD DR, ROSEBURG, OR 97470-1042
(541) 375-2139
Mailing address
150 NE KENNETH FORD DR, ROSEBURG, OR 97470-1042
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PG215464
OR
Other
Enumeration date
01/08/2021
Last updated
06/13/2023
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