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Organization

OREGON SURGICAL SPECIALISTS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAVID L STREET M.D. (PRESIDENT OF CORPORATION)
(541) 930-8907
Entity
Organization

Contact information

Practice address
520 MEDICAL CENTER DR, STE 300, MEDFORD, OR 97504-4316
(541) 930-8907
(541) 282-6710
Mailing address
520 MEDICAL CENTER DR, STE 300, MEDFORD, OR 97504-4316
(541) 930-8907
(541) 282-6710

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2086S0129X
Vascular Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004898000
BLUE CROSS
OR
05
081653
OR
Enumeration date
10/17/2006
Last updated
07/12/2016
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