Organization
APPLEGATE VALLEY FAMILY MEDICINE, LLC
Active
Other names
Applegate Valley Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER M FOGG FNP-C (OWNER)
(541) 862-2836
Entity
Organization
Contact information
Practice address
8600 NEW HOPE RD, GRANTS PASS, OR 97527-8978
(541) 862-2836
(541) 862-2806
Mailing address
8600 NEW HOPE RD, GRANTS PASS, OR 97527-8978
(541) 862-2836
(541) 862-2806
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
222705-99
OR
Other
Enumeration date
09/16/2006
Last updated
05/31/2019
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