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BEND MEMORIAL CLINIC PC

Physicians Dermatology

Provider NPI: 1699827477

Organization Information:
Organization Name:  BEND MEMORIAL CLINIC PC
Organization is not Subpart
Authorized Official:  GREGORY  HAGFORS  CEO  541-706-5401

Practice Location:
1501 NE MEDICAL CENTER DR  BEND, OR 97701-6051 US
Tel: 541-382-2811  Fax: --

Business Mailing Address:
1501 NE MEDICAL CENTER DR  BEND, OR 97701-6051 US
Tel: 541-382-2811  Fax: --

NPI Information:
NPI: 1699827477
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N207N00000XPhysicians
Dermatology
N207ND0101XPhysicians
Dermatology
N207R00000XPhysicians
Internal Medicine
N207RC0000XPhysicians
Internal Medicine
N207RE0101XPhysicians
Internal Medicine
N207RG0100XPhysicians
Internal Medicine
N207RH0003XPhysicians
Internal Medicine
N207RN0300XPhysicians
Internal Medicine
N207RP1001XPhysicians
Internal Medicine
N207RR0500XPhysicians
Internal Medicine
N207W00000XPhysicians
Ophthalmology
N208600000XPhysicians
Surgery
N332B00000XSuppliers
Durable Medical Equipment & Medical Supplies
Y207Q00000XPhysicians
Family Medicine
N207RX0202XPhysicians
Internal Medicine

Other Provider Identifiers:

IssuerNumberStateType
213243OR05



American Medical Association 2012 taxonomy code information

Code: 207Q00000X

Type:

Classification:



Definition:



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