Healthcare Provider Details

I. General information

NPI: 1821918293
Provider Name (Legal Business Name): OREGON SHOULDER INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2780 E BARNETT RD STE 200
MEDFORD OR
97504-8674
US

IV. Provider business mailing address

2780 E BARNETT RD STE 200
MEDFORD OR
97504-8674
US

V. Phone/Fax

Practice location:
  • Phone: 541-779-6250
  • Fax: 541-608-2535
Mailing address:
  • Phone: 541-779-6250
  • Fax: 541-608-2535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: BRANDI A WINTER
Title or Position: ADMINISTRATIVE ASSISTANT
Credential:
Phone: 541-779-6250