Healthcare Provider Details

I. General information

NPI: 1144281577
Provider Name (Legal Business Name): ANDREW GILCHRIST MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 10/08/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

244 COUNTRY CLUB RD
EUGENE OR
97401
US

IV. Provider business mailing address

76 CENTENNIAL LOOP STE C
EUGENE OR
97401-7913
US

V. Phone/Fax

Practice location:
  • Phone: 541-515-7900
  • Fax: 866-521-4035
Mailing address:
  • Phone: 541-515-7900
  • Fax: 866-521-4035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD20671
License Number StateOR

VII. Legacy identifiers

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

# 1
Identifier858463001
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerBCBS-MEDFORD
# 2
IdentifierP00102805
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerRR MEDICARE
# 3
Identifier858464017
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerBCBS-SPRINGFIELD
# 4
IdentifierP00102805
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerRAIL ROAD MEDICARE
# 5
Identifier838334003
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerBCBS-ROSEBURG
# 6
Identifier150497
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: