Healthcare Provider Details
I. General information
NPI: 1578880845
Provider Name (Legal Business Name): JEFFREY SPENCER CHEN MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/27/2010
Last Update Date: 04/24/2020
Certification Date: 04/24/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2500 NE NEFF RD
BEND OR
97701-6015
US
IV. Provider business mailing address
PO BOX 13129
SALEM OR
97309-1129
US
V. Phone/Fax
- Phone: 541-706-5811
- Fax: 541-706-5867
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | MD163508 |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: