Organization
EAR NOSE AND THROAT ASSOCIATES OF GRANTS PASS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNE REECE (OFFICE MANAGER)
(541) 476-7775
Entity
Organization
Contact information
Practice address
1600 NW 6TH ST, SOUTH SUITE, GRANTS PASS, OR 97526-1094
(541) 476-7775
(541) 476-3572
Mailing address
1600 NW 6TH ST, SOUTH SUITE, GRANTS PASS, OR 97526-1094
(541) 476-7775
(541) 476-3572
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
DO20532
OR
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
MD10466
OR
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
MD19356
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
073655
—
OR
05
—
150358
—
OR
05
—
232900
—
OR
Enumeration date
03/07/2007
Last updated
04/24/2014
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