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Organization

MEDFORD MEDICAL CLINIC, LLP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JON KANE VANVALKENBURG M.D. (PARTNER)
(541) 734-3430
Entity
Organization

Contact information

Practice address
555 BLACK OAK DR, SUITE 100, MEDFORD, OR 97504-8447
(541) 734-3430
(541) 734-3666
Mailing address
PO BOX 7841, BELFAST, ME 04915-7800
(541) 734-3430
(541) 734-3666

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD21703
OR
207Q00000X
Family Medicine Physician
OR
207R00000X
Internal Medicine Physician
OR
363L00000X
Nurse Practitioner
OR

Other

Enumeration date
06/30/2005
Last updated
05/06/2014
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