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NPI Code Detail

MEDICARE: CHARLES PELTON SPRAGUE III M.D.

MEDICARE: CHARLES PELTON SPRAGUE III M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianG35009CA

General Provider Information

NPI Number : 1043233638
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES PELTON SPRAGUE III M.D.
Provider Business Mailing Address
First Line : 100 RIVER AVE
Second Line :
City : EUGENE
State : OR
Zip : 97404-2507
Country : US
Telephone Number : 541-607-0897
Fax Number : 541-607-7581
Provider Business Practice Location Address
First Line : 100 RIVER AVE
Second Line :
City : EUGENE
State : OR
Zip : 97404-2507
Country : US
Telephone Number : 541-607-0897
Fax Number : 541-607-7581
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 07/08/2007

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Directions to “ CHARLES PELTON SPRAGUE III M.D.” Practice Location

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