Provider Demographics
NPI:1508169186
Name:JANA VANAMBURG MD PC
Entity Type:Organization
Organization Name:JANA VANAMBURG MD PC
Other - Org Name:VANAMBURG SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VANAMBURG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-749-2282
Mailing Address - Street 1:2400 NE NEFF RD
Mailing Address - Street 2:STE B
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6752
Mailing Address - Country:US
Mailing Address - Phone:541-749-2282
Mailing Address - Fax:
Practice Address - Street 1:2400 NE NEFF RD
Practice Address - Street 2:STE B
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6752
Practice Address - Country:US
Practice Address - Phone:541-749-2282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-21
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty