Healthcare Provider Details

I. General information

NPI: 1831220466
Provider Name (Legal Business Name): THOMAS J ETGES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 2ND AVE STE 103
EUGENE OR
97401-2452
US

IV. Provider business mailing address

400 E 2ND AVE STE 103
EUGENE OR
97401-2452
US

V. Phone/Fax

Practice location:
  • Phone: 541-654-0716
  • Fax: 541-654-0638
Mailing address:
  • Phone: 541-654-0716
  • Fax: 541-654-0638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD18085
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: