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General NPI Number Information
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NPI Number | 1508686502
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Entity Type | Organization
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Legal Business Name | DAVID M TRASK MD LLC
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 492 MURPHY RD
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City | MEDFORD
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State | OR
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Zip | 97504-8144
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Country | US
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Telephone | 541-858-1998
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Fax | 541-772-1513
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Provider Business Mailing Address
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Address Line | 492 MURPHY RD
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City | MEDFORD
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State | OR
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Zip | 97504-8144
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Country | US
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Telephone | 541-858-1998
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Fax | 541-772-1513
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MRS. TERESA ESTELLE HILL
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Credential |
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Telephone | 541-858-1998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number |
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License Number State |
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