Organization
GREGORY A AITCHISON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY ALLEN AITCHISON MD (PRESIDENT)
(541) 347-9042
Entity
Organization
Contact information
Practice address
1295 OREGON AVE, BANDON, OR 97411-9102
(541) 347-9042
(541) 347-4720
Mailing address
PO BOX 189, BANDON, OR 94711-0189
(541) 347-9042
(541) 347-4720
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00024340000
BLUE CROSS
OR
01
—
000845495000
BLUE CROSS
OR
05
—
277384
—
OR
Enumeration date
10/25/2006
Last updated
11/12/2009
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