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General NPI Number Information
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NPI Number | 1861459828
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Entity Type | Organization
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Legal Business Name | ONCOLOGY OF SOUTHERN OREGON LLC
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 748 STATE ST
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City | MEDFORD
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State | OR
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Zip | 97504-8473
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Country | US
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Telephone | 541-282-8888
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Fax | 541-282-8898
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Provider Business Mailing Address
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Address Line | 748 STATE ST
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City | MEDFORD
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State | OR
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Zip | 97504-8473
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Country | US
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Telephone | 541-282-8888
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Fax | 541-282-8898
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NANCY A NOYCE
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Credential | MD
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Telephone | 541-772-5282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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