Healthcare Provider Details

I. General information

NPI: 1497820583
Provider Name (Legal Business Name): FRANCES C MUNKENBECK MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 NW STEWART PARKWAY 200
ROSEBURG OR
97470
US

IV. Provider business mailing address

2700 NW STEWART PARKWAY 200
ROSEBURG OR
97470
US

V. Phone/Fax

Practice location:
  • Phone: 541-677-3545
  • Fax: 541-677-6543
Mailing address:
  • Phone: 541-677-3545
  • Fax: 541-677-6543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD19962
License Number StateOR

VIII. Authorized Official

Name: FRANCES C MUNKENBECK
Title or Position: PHYSICIAN
Credential: MD
Phone: 541-677-3545