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General NPI Number Information
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NPI Number | 1740787456
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Entity Type | Organization
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Legal Business Name | ASHLAND FAMILY PRACTICE LLC
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Dates
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Enumeration Date | 04/09/2018
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 935 SISKIYOU BLVD
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City | ASHLAND
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State | OR
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Zip | 97520
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Country | US
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Telephone | 541-482-2716
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Fax | 541-488-5461
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Provider Business Mailing Address
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Address Line | 935 SISKIYOU BLVD
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City | ASHLAND
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State | OR
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Zip | 97520-2143
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | CYNTHIA A PARKS
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Credential |
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Telephone | 541-482-2716
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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 |
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License Number State |
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