MEDICARE: DOUGLAS FALKNER 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
1	208D00000X	General Practice Physician	MD22753	OR

General Provider Information

NPI Number	:	1427323161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS FALKNER M.D.

Provider Business Mailing Address
First Line	:	240 ORANGE AVE
Second Line	:	240 ORANGE AVENUE
City	:	ASHLAND
State	:	OR
Zip	:	97520-1124
Country	:	US
Telephone Number	:	541-482-3110
Fax Number	:

Provider Business Practice Location Address
First Line	:	1639 JACKSON RD
Second Line	:
City	:	ASHLAND
State	:	OR
Zip	:	97520-9617
Country	:	US
Telephone Number	:	541-552-1400
Fax Number	:

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

Provider Enumeration Date	:	03/13/2012
Last Update Date	:	03/13/2012

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