Organization
ROBERT M GENTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA A WILSON (OFFICE MGR)
(541) 474-5511
Entity
Organization
Contact information
Practice address
1585 NW WASHINGTON BLVD, GRANTS PASS, OR 97526-1049
(541) 474-5511
Mailing address
1585 NW WASHINGTON BLVD, GRANTS PASS, OR 97526-1049
(541) 474-5511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043364
—
OR
Enumeration date
08/07/2007
Last updated
08/13/2007
Update your record
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