Healthcare Provider Details

I. General information

NPI: 1801322953
Provider Name (Legal Business Name): CHRISTOPHER CYCHOSZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 COBURG RD
EUGENE OR
97401-2433
US

IV. Provider business mailing address

55 COBURG RD
EUGENE OR
97401-2433
US

V. Phone/Fax

Practice location:
  • Phone: 541-485-8111
  • Fax: 541-342-6379
Mailing address:
  • Phone: 541-485-8111
  • Fax: 541-342-6379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberR-10844
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number316839
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License NumberMD214370
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: