Provider Demographics
NPI:1457826125
Name:CENTRAL OREGON SURGICAL INSTITUTE, LLC
Entity Type:Organization
Organization Name:CENTRAL OREGON SURGICAL INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:JUNDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-313-8111
Mailing Address - Street 1:1550 NE 27TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-7728
Mailing Address - Country:US
Mailing Address - Phone:541-313-8111
Mailing Address - Fax:541-313-8112
Practice Address - Street 1:1550 NE 27TH ST STE 110
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-7728
Practice Address - Country:US
Practice Address - Phone:541-262-4111
Practice Address - Fax:541-262-4112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-09
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical