Healthcare Provider Details

I. General information

NPI: 1508865015
Provider Name (Legal Business Name): KAREN TRESSER KAHN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 10/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 STEVENS ST
MEDFORD OR
97504-6719
US

IV. Provider business mailing address

625 STEVENS ST
MEDFORD OR
97504-6719
US

V. Phone/Fax

Practice location:
  • Phone: 541-646-2242
  • Fax: 541-488-4081
Mailing address:
  • Phone: 541-646-2242
  • Fax: 541-488-4081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD19081
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: