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General NPI Number Information
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NPI Number | 1871047530
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Entity Type | Individual
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Provider Name | ROGER T ESPLIN
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Gender | Male
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Dates
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Enumeration Date | 08/11/2016
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 4439 HAMRICK RD
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City | CENTRAL POINT
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State | OR
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Zip | 97502-2816
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Country | US
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Telephone | 458-225-9358
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Fax |
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Provider Business Mailing Address
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Address Line | 3126 STATE ST STE 100
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City | MEDFORD
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State | OR
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Zip | 97504-8665
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Country | US
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Telephone | 458-225-9358
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Fax |
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 19-QMHA-I-01546
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License Number State | OR
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