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NPI Code Detail

MEDICARE: ROGER T ESPLIN

MEDICARE: ROGER T ESPLIN
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
1171M00000XCase Manager/Care Coordinator19-QMHA-I-01546OR

General Provider Information

NPI Number : 1871047530
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROGER T ESPLIN
Provider Business Mailing Address
First Line : 3126 STATE ST STE 100
Second Line :
City : MEDFORD
State : OR
Zip : 97504-8665
Country : US
Telephone Number : 458-225-9358
Fax Number :
Provider Business Practice Location Address
First Line : 4439 HAMRICK RD
Second Line :
City : CENTRAL POINT
State : OR
Zip : 97502-2816
Country : US
Telephone Number : 458-225-9358
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2016
Last Update Date : 12/08/2025

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