Individual
DR. RICHARD KELLY STAGGENBORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1010 1ST ST SE, BANDON, OR 97411-9301
(541) 347-4736
(541) 347-1098
Mailing address
1010 1ST ST SE, BANDON, OR 97411-9301
(541) 347-4736
(541) 347-1098
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
20053
OR
Other
Enumeration date
07/11/2006
Last updated
07/08/2007
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