Individual
DR. PHILIP CAREY LAGESSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-0000
(541) 267-5151
(541) 266-4534
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-0000
(541) 267-5151
(541) 266-4534
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD16611
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032099
—
OR
01
—
1407812365
NBMC NPI NUMBER-GROUP
OR
01
—
R0000WFBTV
MEDICARE GROUP PIN NUMBER
OR
Enumeration date
12/06/2005
Last updated
03/22/2010
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