Provider Demographics
NPI:1104838093
Name:HAND AND ARM SURGERY OF SOUTHERN OREGON, PC
Entity Type:Organization
Organization Name:HAND AND ARM SURGERY OF SOUTHERN OREGON, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:APPLEBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-955-0585
Mailing Address - Street 1:1619 NW HAWTHORNE AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-6008
Mailing Address - Country:US
Mailing Address - Phone:541-955-0585
Mailing Address - Fax:
Practice Address - Street 1:1619 NW HAWTHORNE AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-6008
Practice Address - Country:US
Practice Address - Phone:541-955-0585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD14721174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR111579Medicare PIN
ORC91068Medicare UPIN