Healthcare Provider Details

I. General information

NPI: 1821032350
Provider Name (Legal Business Name): RODNEY WARNER SCHAFFER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 2ND AVE SUITE 105
EUGENE OR
97401-2452
US

IV. Provider business mailing address

400 E 2ND AVE SUITE 105
EUGENE OR
97401-2452
US

V. Phone/Fax

Practice location:
  • Phone: 541-484-9229
  • Fax: 541-485-3602
Mailing address:
  • Phone: 541-484-9229
  • Fax: 541-485-3602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD16442
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier008537
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: