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NPI Code Detail

MEDICARE: DR. QUINN MARIE SCALLON MD

MEDICARE: DR. QUINN MARIE SCALLON MD
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
1207Q00000XFamily Medicine PhysicianMD25747OR

Other Identifiers

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

General Provider Information

NPI Number : 1588774426
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. QUINN MARIE SCALLON MD
Provider Business Mailing Address
First Line : PO BOX 1710
Second Line :
City : REDMOND
State : OR
Zip : 97756-0516
Country : US
Telephone Number : 541-516-4099
Fax Number :
Provider Business Practice Location Address
First Line : 2555 MAIN ST
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97601-2723
Country : US
Telephone Number : 541-516-4099
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 04/09/2025

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Directions to “ DR. QUINN MARIE SCALLON MD” Practice Location

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