Provider Demographics
NPI:1467971739
Name:DAVID DRYLAND, PC
Entity Type:Organization
Organization Name:DAVID DRYLAND, PC
Other - Org Name:DAVID DRYLAND PC
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHASTAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-488-4464
Mailing Address - Street 1:1365 POPLAR DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-5207
Mailing Address - Country:US
Mailing Address - Phone:541-773-2233
Mailing Address - Fax:541-773-7089
Practice Address - Street 1:1801 HIGHWAY 99 N STE 2
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-9152
Practice Address - Country:US
Practice Address - Phone:541-625-6555
Practice Address - Fax:541-625-2968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-18
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22976207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty