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Individual

KALSANG W PHUNTSHOG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
380 9TH ST, FLORENCE, OR 97439-9470
(541) 997-7134
(541) 997-9650
Mailing address
PO BOX 24410, EUGENE, OR 97402-0451
(541) 902-6140
(541) 902-7533

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD18884
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MD18884
STATE LICENSE
OR
Enumeration date
04/26/2006
Last updated
12/07/2009
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