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NPI Code Detail

MEDICARE: CASCADE ORTHOPEDICS & SPORTS MEDICINE CENTER, PC

MEDICARE: CASCADE ORTHOPEDICS & SPORTS MEDICINE CENTER, PC
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
1332B00000XDurable Medical Equipment & Medical Supplies
2207X00000XOrthopaedic Surgery Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841366010
Entity Type Code : Organization
Provider Name (Legal Business Name) : CASCADE ORTHOPEDICS & SPORTS MEDICINE CENTER, PC
Provider Business Mailing Address
First Line : 1715 E 12TH ST
Second Line :
City : THE DALLES
State : OR
Zip : 97058-3136
Country : US
Telephone Number : 541-296-2294
Fax Number : 541-298-4123
Provider Business Practice Location Address
First Line : 1715 E 12TH ST
Second Line :
City : THE DALLES
State : OR
Zip : 97058-3136
Country : US
Telephone Number : 541-296-2294
Fax Number : 541-298-4123
Authorized Official
Title or Position : CORPORATE OFFICER
Name : MR. GREGROY M STANLEY
Credential : M.D.
Telephone Number : 541-296-2294
Provider Enumeration Date : 11/28/2006
Last Update Date : 03/19/2015

Similar Medicare Providers

1184580441 — NATALIE CLARK PA-C
Practice Location Address:
1715 E 12TH ST
THE DALLES, OR
97058-3136
Practice Phone: 541-296-2294
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1336137561 — GREGORY M STANLEY MD
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1699763821 — ROBERT A STAVER MD
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1548471410 — JOSEPH SANTO SACAMANO M.D.
Practice Location Address:
1715 E 12TH ST
THE DALLES, OR
97058-3136
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Practice Fax:
1720405145 — THOMAS KOEHLER PA-C
Practice Location Address:
1715 E 12TH ST
THE DALLES, OR
97058-3136
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1265010185 — CAMERON LEE MCMAHEN DPM
Practice Location Address:
1715 E 12TH ST
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97058-3136
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Directions to “CASCADE ORTHOPEDICS & SPORTS MEDICINE CENTER, PC ” Practice Location

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