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General NPI Number Information
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NPI Number | 1013922996
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Entity Type | Organization
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Legal Business Name | A.K. GOMBART M.D.P.C
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 532 W UMPQUA ST
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City | ROSEBURG
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State | OR
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Zip | 97470-2951
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Country | US
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Telephone | 541-673-0133
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Fax |
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Provider Business Mailing Address
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Address Line | 532 W UMPQUA ST
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City | ROSEBURG
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State | OR
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Zip | 97470-2951
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Country | US
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Telephone | 541-673-0133
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. AUGUSTIN KARL GOMBART
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Credential | MD
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Telephone | 541-673-0133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD08874
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License Number State | OR
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