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Individual

DYLAN RAY MATHIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
520 SW RAMSEY AVE, GRANTS PASS, OR 97527-5535
(541) 472-7810
Mailing address
520 SW RAMSEY AVE, GRANTS PASS, OR 97527-5535
(541) 472-7810

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO226103
OR
390200000X
Student in an Organized Health Care Education/Training Program
1922748102
OR
390200000X
Student in an Organized Health Care Education/Training Program
PG210858
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PG210858
OR
Enumeration date
03/29/2022
Last updated
07/02/2025
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