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Organization

KLAMATH SURGICAL ASSOCIATES PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDWARD THOMAS MCCLURE M.D. (OWNER)
(541) 883-3391
Entity
Organization

Contact information

Practice address
2200 BRYANT WILLIAMS DR, KLAMATH FALLS, OR 97601-1120
(541) 883-3391
(541) 883-2250
Mailing address
PO BOX 1359, KLAMATH FALLS, OR 97601-0075
(541) 882-1540
(541) 882-2583

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD11222
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006213
OR
01
CN5695
RAILROAD MEDICARE
Enumeration date
01/16/2007
Last updated
11/02/2007
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