Provider Demographics
NPI:1063437127
Name:GARRETT, AUDREY PAIGE (MD , MPH)
Entity type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:PAIGE
Last Name:GARRETT
Suffix:
Gender:F
Credentials:MD , MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 COUNTRY CLUB PKWY
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6036
Mailing Address - Country:US
Mailing Address - Phone:541-683-5001
Mailing Address - Fax:541-683-1422
Practice Address - Street 1:520 COUNTRY CLUB PKWY
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6036
Practice Address - Country:US
Practice Address - Phone:541-683-5001
Practice Address - Fax:541-683-1422
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD23833207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR286372Medicaid
OR113852Medicare ID - Type Unspecified
OR286372Medicaid