Healthcare Provider Details

I. General information

NPI: 1912314279
Provider Name (Legal Business Name): RISHI SHRAVAN ARORA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2014
Last Update Date: 07/20/2020
Certification Date: 07/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 BLACK OAK DR STE 300
MEDFORD OR
97504-8491
US

IV. Provider business mailing address

1501 KINGS HWY
SHREVEPORT LA
71103-4228
US

V. Phone/Fax

Practice location:
  • Phone: 541-789-8100
  • Fax: 541-789-8101
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD196275
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD196275
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: