Healthcare Provider Details

I. General information

NPI: 1265431944
Provider Name (Legal Business Name): ALAN A BINETTE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

691 MURPHY RD SUITE 232
MEDFORD OR
97504-4346
US

IV. Provider business mailing address

691 MURPHY RD SUITE 232
MEDFORD OR
97504-4346
US

V. Phone/Fax

Practice location:
  • Phone: 541-773-3018
  • Fax: 541-773-3093
Mailing address:
  • Phone: 541-773-3018
  • Fax: 541-773-3093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD14303
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: