Unknown Individual – Family Medicine Physician, NPI 1164428017
Family Medicine Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
2570, Northwest Edenbower Boulevard, Roseburg, Douglas County, Oregon, 97471, United States
STE 100
ROSEBURG, OR 97470
Phone: (541) 957-1111
Fax: (541) 957-5705
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97470)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | OR | 81002 | Urinalysis, manual test | 51 | 49 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OR | |
| Nurse Practitioner | TX | |
| Family Practice | OR | |
| Physician Assistant | TN | |
| Nurse Practitioner | OR | |
| Nurse Practitioner | OR | |
| Physician Assistant | NY | |
| Physician Assistant | OR | |
| - | OR | |
| - | OR |
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