Organization
EYECARE ASSOCIATES OF SOUTHERN OREGON PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN K MITCHELL O. D. (PRESIDENT)
(541) 779-2211
Entity
Organization
Contact information
Practice address
935 ROYAL AVE, MEDFORD, OR 97504-6140
(541) 779-2211
(541) 779-8778
Mailing address
935 ROYAL AVE, MEDFORD, OR 97504-6140
(541) 779-2211
(541) 779-8778
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3079AT
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026488
—
OR
05
—
064886
—
OR
05
—
229948
—
OR
Enumeration date
10/26/2006
Last updated
06/16/2011
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