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General NPI Number Information
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NPI Number | 1356425169
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Entity Type | Organization
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Legal Business Name | UMPQUA ORTHOPEDICS
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2801 NW MERCY DR STE 300
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City | ROSEBURG
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State | OR
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Zip | 97470-2348
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Country | US
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Telephone | 541-677-2131
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Fax | 541-677-2136
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Provider Business Mailing Address
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Address Line | 277 NW MEDICAL LOOP
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City | ROSEBURG
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State | OR
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Zip | 97471-1644
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Country | US
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Telephone | 541-677-2131
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Fax | 541-677-2136
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Authorized Official
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Title or Position | PARTNER
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Name | DR. MICHAEL J KRNACIK
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Credential | M.D., PH.D
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Telephone | 541-677-2131
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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 |
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License Number State | OR
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