Provider Demographics
NPI:1215194980
Name:ANDREA L. HALLIDAY, M.D., P.C.
Entity Type:Organization
Organization Name:ANDREA L. HALLIDAY, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:LOIS
Authorized Official - Last Name:HALLIDAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-485-2357
Mailing Address - Street 1:1410 OAK ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4604
Mailing Address - Country:US
Mailing Address - Phone:541-485-2357
Mailing Address - Fax:541-485-2358
Practice Address - Street 1:1410 OAK ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4604
Practice Address - Country:US
Practice Address - Phone:541-485-2357
Practice Address - Fax:541-485-2358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD25669261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service