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General NPI Number Information
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NPI Number | 1487956512
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Entity Type | Organization
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Legal Business Name | LANCASTER MEDICAL CLINIC
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Dates
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Enumeration Date | 11/22/2010
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Last Update Date | 11/22/2010
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Provider Practice Location Address
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Address Line | 1880 LANCASTER DR NE SUITE 127
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City | SALEM
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State | OR
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Zip | 97305-1089
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Country | US
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Telephone | 503-581-1113
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Fax | 503-363-4997
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Provider Business Mailing Address
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Address Line | 2252 LLOYD CTR
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City | PORTLAND
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State | OR
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Zip | 97232-1311
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Country | US
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Telephone | 503-282-2502
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Fax | 503-249-0407
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | FLOYD DOUGLAS DAY
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Credential | M.D.
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Telephone | 503-282-2502
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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 | MD05881
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD05881
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD05881
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License Number State | OR
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