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Individual

DR. JEREMY JOHN HITCHCOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
495 SW RAMSEY AVE, GRANTS PASS, OR 97527
(541) 476-6644
(541) 472-5673
Mailing address
495 SW RAMSEY AVE, GRANTS PASS, OR 97527
(541) 476-6644
(541) 472-5673

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD28543
OR
207VX0000X
Obstetrics Physician
MD28543
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
025998
OR
Enumeration date
06/28/2007
Last updated
08/13/2012
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