Individual
JACK GUILLERMO SIBAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4940 HAMRICK RD, CENTRAL POINT, OR 97502-3072
(541) 690-3600
(541) 664-3735
Mailing address
3617 S PACIFIC HWY, MEDFORD, OR 97501-8957
(541) 535-6239
(541) 512-1026
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA184052
OR
363AM0700X
Medical Physician Assistant
14456
CA
Other
Enumeration date
01/17/2006
Last updated
03/17/2018
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