Healthcare Provider Details

I. General information

NPI: 1538272869
Provider Name (Legal Business Name): MARY C SKRZYNSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARY C HEFELE MD

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 05/18/2025
Certification Date: 05/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 NE MEDICAL CENTER DR
BEND OR
97701-6051
US

IV. Provider business mailing address

2155 NW HIGH LAKES LOOP
BEND OR
97701-6705
US

V. Phone/Fax

Practice location:
  • Phone: 541-382-4900
  • Fax:
Mailing address:
  • Phone: 541-639-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberMD19014
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: