Individual
DR. PETER BOGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
700 RAMSEY AVE, STE 104, GRANTS PASS, OR 97527-5788
(541) 471-4930
(541) 471-1331
Mailing address
700 RAMSEY AVE, STE 104, GRANTS PASS, OR 97527-5788
(541) 471-4930
(541) 471-1331
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
DO18557
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
058748
—
OR
Enumeration date
05/24/2005
Last updated
03/17/2008
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