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General NPI Number Information
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NPI Number | 1356665103
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Entity Type | Organization
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Legal Business Name | OREGON FOOT & ANKLE SURGICAL SPECIALIST, LLC
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Dates
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Enumeration Date | 03/23/2010
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Last Update Date | 11/12/2010
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Provider Practice Location Address
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Address Line | 1661 HWY 99 N SUITE 201
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City | ASHLAND
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State | OR
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Zip | 97520-8900
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Country | US
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Telephone | 541-482-4924
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Fax | 541-488-1732
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Provider Business Mailing Address
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Address Line | 1661 HWY 99 N SUITE 201
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City | ASHLAND
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State | OR
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Zip | 97520-8900
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Country | US
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Telephone | 541-482-4924
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Fax | 541-488-1732
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Authorized Official
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Title or Position | OWNER
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Name | LYNN WILLIAM RAWCLIFFE
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Credential | DPM
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Telephone | 541-482-4926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | DP00358
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License Number State | OR
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