Organization
DERMATOLOGY AND LASER ASSOCIATES OF MEDFORD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS N NAVERSEN MD (PARTNER)
(541) 773-3636
Entity
Organization
Contact information
Practice address
2959 SISKIYOU BLVD, #B, MEDFORD, OR 97504-8131
(541) 773-3636
(541) 245-9147
Mailing address
2959 SISKIYOU BLVD, #B, MEDFORD, OR 97504-8131
(541) 773-3636
(541) 245-9147
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287341
—
OR
Enumeration date
01/23/2007
Last updated
06/06/2017
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