Healthcare Provider Details

I. General information

NPI: 1760019046
Provider Name (Legal Business Name): JACOB HUNTER CREIGHTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 MEDICAL CENTER DR STE 300
MEDFORD OR
97504-4316
US

IV. Provider business mailing address

520 MEDICAL CENTER DR STE 300
MEDFORD OR
97504-4316
US

V. Phone/Fax

Practice location:
  • Phone: 541-930-8900
  • Fax: 541-245-4808
Mailing address:
  • Phone: 541-930-8900
  • Fax: 541-245-4808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD229534
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberMD229534
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: