Provider Demographics
NPI:1003822230
Name:YORK, JOHN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:YORK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 70368
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-0120
Mailing Address - Country:US
Mailing Address - Phone:541-686-2922
Mailing Address - Fax:541-683-1709
Practice Address - Street 1:590 COUNTRY CLUB PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6025
Practice Address - Country:US
Practice Address - Phone:541-686-2922
Practice Address - Fax:541-683-1709
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD08786207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR231027Medicaid
ORC91042Medicare UPIN
OR00WCJNMDMedicare ID - Type Unspecified