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General NPI Number Information
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NPI Number | 1639197742
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Entity Type | Individual
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Provider Name | MARTHA MARIE CAVAZOS MD
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Gender | Female
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 560 CATALINA DR
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City | ASHLAND
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State | OR
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Zip | 97520-1605
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Country | US
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Telephone | 541-201-4800
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Fax | 541-201-4815
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Provider Business Mailing Address
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Address Line | 2620 E BARNETT RD
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City | MEDFORD
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State | OR
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Zip | 97504-8344
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Country | US
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Telephone | 541-789-4281
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Fax | 541-789-2558
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MD25511
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License Number State | OR
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