Organization
ROGUE VALLEY FOOT CLINIC P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK THEODORE CODE DPM (CEO)
(541) 773-3338
Entity
Organization
Contact information
Practice address
2655 SISKIYOU BLVD, MEDFORD, OR 97504-8125
(541) 773-3338
(541) 772-9526
Mailing address
2655 SISKIYOU BLVD, MEDFORD, OR 97504-8125
(541) 773-3338
(541) 772-9526
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
DP002200
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
034947
—
OR
Enumeration date
01/24/2007
Last updated
02/09/2010
Update your record
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