Healthcare Provider Details

I. General information

NPI: 1669191524
Provider Name (Legal Business Name): EUGENE FAMILY MEDICINE ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

995 WILLAGILLESPIE RD STE 300
EUGENE OR
97401-2153
US

IV. Provider business mailing address

995 WILLAGILLESPIE RD STE 300
EUGENE OR
97401-2153
US

V. Phone/Fax

Practice location:
  • Phone: 541-357-3253
  • Fax:
Mailing address:
  • Phone: 541-357-3253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER CARROLL
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 541-357-3253