Provider Demographics
NPI:1679758189
Name:MEYERDING SURGICAL ASSOCIATES INC
Entity Type:Organization
Organization Name:MEYERDING SURGICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MEYERDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-773-3248
Mailing Address - Street 1:2924 SISKIYOU BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6462
Mailing Address - Country:US
Mailing Address - Phone:541-773-3248
Mailing Address - Fax:541-779-5356
Practice Address - Street 1:2924 SISKIYOU BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6264
Practice Address - Country:US
Practice Address - Phone:541-773-3248
Practice Address - Fax:541-779-5356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0000WCHGPMedicare PIN