Organization
JASON M CONAUGHTY MD PC
Active
Other names
Jason M Conaughty MD
Organization subpart
No
Provider details
NPI number
Authorized official
JEANETTE L GANSBERG (EXECUTIVE DIRECTOR)
(541) 274-2902
Entity
Organization
Contact information
Practice address
2200 BRYANT WILLIAMS DR, SUITE 1, KLAMATH FALLS, OR 97601-1120
(541) 884-7746
(541) 884-0848
Mailing address
2200 BRYANT WILLIAMS DR, SUITE 1, KLAMATH FALLS, OR 97601-1120
(541) 884-7746
(541) 884-0848
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD151649
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
512922000
BLUE CROSS
OR
01
—
DS2164
RAIL ROAD MEDICARE
OR
Enumeration date
08/30/2011
Last updated
11/14/2017
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