Organization
BEND MEMORIAL CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY HAGFORS (CEO)
(541) 706-5401
Entity
Organization
Contact information
Practice address
1080 MOUNT BACHELOR DR, BEND, OR 97702-3280
(541) 550-4400
Mailing address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-2811
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
174400000X
Specialist
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207W00000X
Ophthalmology Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
06/03/2009
Last updated
02/10/2012
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