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Organization

JAY N. GADE M.D., PHD., PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAY N GADE M.D., PHD. (OWNER)
(541) 957-1141
Entity
Organization

Contact information

Practice address
2440 NW EDENBOWER BLVD., ROSEBURG, OR 97471-6220
(541) 957-1141
Mailing address
2440 NW EDENBOWER BLVD., ROSEBURG, OR 97471-6220
(541) 957-1141

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD20360
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
150092
OR
Enumeration date
02/06/2009
Last updated
07/27/2011
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