Organization
MEDFORD NEURO CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL STEVEN NARUS DO (PRESIDENT)
(541) 779-1672
Entity
Organization
Contact information
Practice address
2900 STATE ST, MEDFORD, OR 97504-8475
(541) 779-1672
(541) 618-9434
Mailing address
2900 STATE ST, MEDFORD, OR 97504-8475
(541) 779-1672
(541) 618-9434
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
—
—
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028571
—
OR
01
—
R0000WCGJP
MEDICARE
OR
Enumeration date
07/26/2005
Last updated
07/10/2007
Update your record
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