Provider Demographics
NPI:1225176191
Name:ARMITAGE, DAMON BRICE (MD)
Entity Type:Individual
Prefix:DR
First Name:DAMON
Middle Name:BRICE
Last Name:ARMITAGE
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 1060
Mailing Address - Street 2:
Mailing Address - City:CRESWELL
Mailing Address - State:OR
Mailing Address - Zip Code:97426-1060
Mailing Address - Country:US
Mailing Address - Phone:541-658-5301
Mailing Address - Fax:541-658-5304
Practice Address - Street 1:170 MELTON RD
Practice Address - Street 2:
Practice Address - City:CRESWELL
Practice Address - State:OR
Practice Address - Zip Code:97426-9453
Practice Address - Country:US
Practice Address - Phone:541-658-5301
Practice Address - Fax:541-658-5304
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2008-0576207Q00000X, 2083A0100X
ORMD27022207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORMD27022OtherOREGON BOARD OF MEDICINE
NMMD2008-0576OtherNEW MEXICO MEDICAL BOARD LICENSE NUMBER