NPI 1336294321 · live from the CMS NPI Registry
Dermatology And Laser Associates Of Medford
Dermatology in Medford, OR. National Provider Identifier 1336294321, active.
NPI record
| NPI | 1336294321 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 2959 Siskiyou Blvd, #B, Medford, OR 97504 |
| Practice phone | 541-773-3636 |
| Enumerated | January 23, 2007 |
| Last updated | June 6, 2017 |
| Authorized official | Douglas Naversen, Partner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | — (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.