Individual
DR. LINDY SUE DEATHERAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
842 E MAIN ST, ANESTHESIA ASSOC OF MEDFORD, PC, MEDFORD, OR 97504-7134
(541) 773-7273
(541) 773-2027
Mailing address
PO BOX 1705, ANESTHESIA ASSOC OF MEDFORD, PC, MEDFORD, OR 97501-0132
(541) 773-7273
(541) 773-2027
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
63518691205
UT
207L00000X
Anesthesiology Physician
Primary
MD28956
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500606314
—
OR
Enumeration date
04/19/2008
Last updated
01/13/2012
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