Individual
MS. MACKENZIE CUMMINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
520 MEDICAL CENTER DR STE 300, MEDFORD, OR 97504-4316
(541) 930-8907
(541) 245-4820
Mailing address
520 MEDICAL CENTER DR STE 300, MEDFORD, OR 97504-4316
(541) 930-8907
(541) 245-4820
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA218550
OR
363AS0400X
Surgical Physician Assistant
PA218550
OR
Other
Enumeration date
06/13/2022
Last updated
05/01/2024
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