Provider Demographics
NPI:1346425063
Name:SYLVIA SEROUSSI CHATROUX MD PC
Entity Type:Organization
Organization Name:SYLVIA SEROUSSI CHATROUX MD PC
Other - Org Name:HERSEY HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:SEROUSSI
Authorized Official - Last Name:CHATROUX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-482-7047
Mailing Address - Street 1:400 W HERSEY ST
Mailing Address - Street 2:#1
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1854
Mailing Address - Country:US
Mailing Address - Phone:541-482-7047
Mailing Address - Fax:541-552-1009
Practice Address - Street 1:400 W HERSEY ST
Practice Address - Street 2:#1
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1854
Practice Address - Country:US
Practice Address - Phone:541-482-7047
Practice Address - Fax:541-552-1009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD17058207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORE98086Medicare UPIN
ORR134420Medicare PIN
ORR134421Medicare PIN