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General NPI Number Information
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NPI Number | 1104838093
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Entity Type | Organization
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Legal Business Name | HAND AND ARM SURGERY OF SOUTHERN OREGON, PC
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 09/04/2009
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Provider Practice Location Address
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Address Line | 1619 NW HAWTHORNE AVE SUITE 106
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City | GRANTS PASS
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State | OR
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Zip | 97526-6008
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Country | US
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Telephone | 541-955-0585
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Fax |
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Provider Business Mailing Address
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Address Line | 1619 NW HAWTHORNE AVE SUITE 106
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City | GRANTS PASS
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State | OR
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Zip | 97526-6008
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Country | US
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Telephone | 541-955-0585
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. DAVID M APPLEBY
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Credential | MD
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Telephone | 541-955-0585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD14721
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License Number State | OR
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