Individual
ANTHONY J FILLMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-2811
Mailing address
PO BOX 6048, BEND, OR 97708-6048
(541) 382-2811
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
K5524
TX
208600000X
Surgery Physician
MD172665
OR
2086S0105X
Surgery of the Hand (Surgery) Physician
K5524
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150379901
—
TX
05
—
500687985
—
OR
01
—
MD172665
OR-LICENSE
OR
Enumeration date
12/15/2005
Last updated
07/02/2025
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