Provider Demographics
NPI:1124057542
Name:OREGON CARDIOLOGY, P.C.
Entity type:Organization
Organization Name:OREGON CARDIOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:L
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-684-3761
Mailing Address - Street 1:677 E 12TH AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3611
Mailing Address - Country:US
Mailing Address - Phone:541-484-4332
Mailing Address - Fax:541-302-0786
Practice Address - Street 1:677 E. 12TH AVENUE
Practice Address - Street 2:SUITE 400
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3611
Practice Address - Country:US
Practice Address - Phone:541-484-4332
Practice Address - Fax:541-302-0786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR000WCPFWMedicare PIN