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Organization

INSTITUTE OF DIABETES AND ENDOCRINOLOGY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RICHARD L EDDY MD (PRESIDENT CEO)
(541) 776-2003
Entity
Organization

Contact information

Practice address
221 W STEWART AVE, SUITE 101, MEDFORD, OR 97501-3609
(541) 776-2003
(541) 796-9833
Mailing address
221 W STEWART AVE, SUITE 101, MEDFORD, OR 97501-3609
(541) 776-2003
(541) 796-9833

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD21000
OR
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
MD21518
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
831237000
BLUE CROSS
OR
Enumeration date
09/27/2005
Last updated
09/11/2025
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