Individual
JONATHAN MICHAEL GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
444 NW ELKS DR, CORVALLIS, OR 97330-3745
(541) 754-1256
(360) 517-1472
Mailing address
520 COUNTRY CLUB RD, EUGENE, OR 97401-6043
(541) 683-5001
(541) 683-1422
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD165536
OR
207RX0202X
Medical Oncology Physician
Primary
MD165536
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500673731
—
OR
Enumeration date
03/31/2009
Last updated
03/18/2020
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