MEDICARE: SIOBHAN A OREILLY DO

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
1	207R00000X	Internal Medicine Physician	DO19967	OR
2	208M00000X	Hospitalist Physician	DO19967	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053395160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIOBHAN A OREILLY DO

Provider Business Mailing Address
First Line	:	PO BOX 1700
Second Line	:
City	:	ROSEBURG
State	:	OR
Zip	:	97470-0414
Country	:	US
Telephone Number	:	541-464-5400
Fax Number	:	541-464-5411

Provider Business Practice Location Address
First Line	:	272 MEDICAL LOOP
Second Line	:	SUITE B
City	:	ROSEBURG
State	:	OR
Zip	:	97471-5597
Country	:	US
Telephone Number	:	541-464-5400
Fax Number	:	541-464-5411

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	09/21/2017

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Directions to “ SIOBHAN A OREILLY DO” Practice Location

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