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Organization

RICHARD C. BOUGHN, MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RIC HARD C BOUGHN MD (PRESIDENT)
(503) 769-7771
Entity
Organization

Contact information

Practice address
613 N 1ST AVE, STAYTON, OR 97383-1704
(503) 769-7771
(503) 769-4630
Mailing address
613 N 1ST AVE, STAYTON, OR 97383-1704
(503) 769-7771
(503) 769-4630

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
072678
OR
Enumeration date
06/30/2010
Last updated
05/27/2020
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