Organization
SOUTHERN OREGON EAR NOSE & THROAT P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDI S BOUCHER (OFFICE MANAGER)
(541) 734-3610
Entity
Organization
Contact information
Practice address
555 BLACK OAK DR STE 210, MEDFORD, OR 97504-8491
(541) 734-3540
Mailing address
555 BLACK OAK DR STE 210, MEDFORD, OR 97504-8491
(541) 734-3540
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
MD17390
OR
Other
Enumeration date
01/14/2008
Last updated
03/10/2022
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