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General NPI Number Information
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NPI Number | 1710114343
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Entity Type | Organization
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Legal Business Name | ROGUE RIVER PALLIATIVE MEDICINE, LLC
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Dates
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Enumeration Date | 06/22/2009
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Last Update Date | 09/14/2009
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Provider Practice Location Address
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Address Line | 979 WINDEMAR DR
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City | ASHLAND
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State | OR
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Zip | 97520-9747
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Country | US
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Telephone | 541-646-8575
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Fax |
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Provider Business Mailing Address
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Address Line | 1208 BEALL LN
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City | CENTRAL POINT
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State | OR
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Zip | 97502-1573
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Country | US
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Telephone | 541-664-5151
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Fax | 541-664-5155
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | MARGUERITE DAVIS WILKINS
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Credential | MD
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Telephone | 541-646-8575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD27812
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License Number State | OR
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