Organization
ROSEBURG FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLYDE A KEYS M.D. (OWNER)
(541) 677-6599
Entity
Organization
Contact information
Practice address
340 NW MEDICAL LOOP, ROSEBURG, OR 97471-1645
(541) 677-6599
(541) 677-6576
Mailing address
340 NW MEDICAL LOOP, ROSEBURG, OR 97471-1645
(541) 677-6599
(541) 677-6576
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD18437
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R0000WCYBS
IDENTIFICATION NUMBER
OR
Enumeration date
05/01/2007
Last updated
12/30/2014
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