NPI 1912963679 · live from the CMS NPI Registry
Jill A Antoine, MD
Anesthesiology in Medford, OR. National Provider Identifier 1912963679, active.
NPI record
| NPI | 1912963679 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Anesthesiology 207L00000X |
| Practice location | 1093 Royal Ct, Medford, OR 97504 |
| Practice phone | 541-773-7273 |
| Mailing address | Po Box 1705, Medford, OR 97501 |
| Enumerated | April 21, 2006 |
| Last updated | November 18, 2019 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Anesthesiology | 207L00000X | G85473 (CA) |
| Anesthesiology | 207L00000X | 218621 (MA) |
| Anesthesiology primary | 207L00000X | MD192745 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.