Provider Demographics
NPI:1407306475
Name:ASANTE PHYSCIAN PARTNERS
Entity Type:Organization
Organization Name:ASANTE PHYSCIAN PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REFERRAL CLERK
Authorized Official - Prefix:
Authorized Official - First Name:CARMAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:DELPIZZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-789-8533
Mailing Address - Street 1:520 SW RAMSEY AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-5535
Mailing Address - Country:US
Mailing Address - Phone:541-789-8533
Mailing Address - Fax:541-789-2173
Practice Address - Street 1:520 SW RAMSEY AVE
Practice Address - Street 2:STE 101
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-5535
Practice Address - Country:US
Practice Address - Phone:541-789-8533
Practice Address - Fax:541-789-2173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO163300364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily HealthGroup - Single Specialty