MEDICARE: UMPQUA ORTHOPEDICS

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	174400000X	Specialist		OR

General Provider Information

NPI Number	:	1356425169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UMPQUA ORTHOPEDICS

Provider Business Mailing Address
First Line	:	277 NW MEDICAL LOOP
Second Line	:
City	:	ROSEBURG
State	:	OR
Zip	:	97471-1644
Country	:	US
Telephone Number	:	541-677-2131
Fax Number	:	541-677-2136

Provider Business Practice Location Address
First Line	:	2801 NW MERCY DR
Second Line	:	STE 300
City	:	ROSEBURG
State	:	OR
Zip	:	97470-2348
Country	:	US
Telephone Number	:	541-677-2131
Fax Number	:	541-677-2136

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. MICHAEL J KRNACIK
Credential	:	M.D., PH.D
Telephone Number	:	541-677-2131

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	07/21/2022

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Directions to “UMPQUA ORTHOPEDICS ” Practice Location

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