Organization
ROXYANN DERMATOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LILIANA RAYBURN (OFFICE MANAGER)
(541) 261-6412
Entity
Organization
Contact information
Practice address
3210 HILLCREST PARK DR STE 100, MEDFORD, OR 97504-7687
(541) 261-6412
Mailing address
6200 HILLCREST RD, MEDFORD, OR 97504-9037
(541) 261-6412
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
226802
—
OR
Enumeration date
07/02/2020
Last updated
07/02/2020
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