Organization
SOUTHERN OREGON INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI S WAGNER CEO (CEO)
(541) 282-2217
Entity
Organization
Contact information
Practice address
2900 DOCTORS PARK DR, MEDFORD, OR 97504-8127
(541) 282-2208
(541) 282-2237
Mailing address
2900 DOCTORS PARK DR, MEDFORD, OR 97504-8127
(541) 282-2208
(541) 282-2237
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
04/09/2007
Last updated
08/22/2020
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