Organization
PARAGON ORTHOPEDIC CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELONY KIMMEL (MANAGER)
(541) 472-0603
Entity
Organization
Contact information
Practice address
702 RAMSEY AVE, STE 112, GRANTS PASS, OR 97527-5573
(541) 472-0603
(541) 472-0609
Mailing address
702 SW RAMSEY AVE, STE 112, GRANTS PASS, OR 97527-5858
(541) 472-0603
(541) 472-0609
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
1148312-9
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286970
—
OR
01
—
CJ7205
MEDICARE RAILROAD
OR
Enumeration date
05/31/2005
Last updated
02/06/2009
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