Provider Demographics
NPI:1659970168
Name:CENTRAL OREGON RADIOLOGY ASSOC., P.C.
Entity Type:Organization
Organization Name:CENTRAL OREGON RADIOLOGY ASSOC., P.C.
Other - Org Name:CORA VASCULAR INTERVENTIONAL SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF PATIENT ADMIN SRVS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-598-3232
Mailing Address - Street 1:1460 NE MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6061
Mailing Address - Country:US
Mailing Address - Phone:541-382-6633
Mailing Address - Fax:541-382-2719
Practice Address - Street 1:1475 SW CHANDLER AVE STE 202
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3240
Practice Address - Country:US
Practice Address - Phone:541-312-5522
Practice Address - Fax:541-382-2719
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL OREGON RADIOLOGY ASSOC PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-26
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Single Specialty