Provider Demographics
NPI:1609986108
Name:DELPLANCHE, CURTIS GREGORY (OD, MD)
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:GREGORY
Last Name:DELPLANCHE
Suffix:
Gender:M
Credentials:OD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3158
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3158
Mailing Address - Country:US
Mailing Address - Phone:541-734-3430
Mailing Address - Fax:541-734-3638
Practice Address - Street 1:3225 HILLCREST PARK DRIVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504
Practice Address - Country:US
Practice Address - Phone:541-734-3430
Practice Address - Fax:541-734-3638
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD272232084N0400X, 2084S0012X
WAMD000446842084S0012X, 2084N0400X
AL000270602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009941683Medicaid
MS08072519Medicaid
OR274757Medicaid
AL009941682Medicaid
AL009941683Medicaid
ORR184567Medicare PIN
WAG8909051Medicare PIN