Provider Demographics
NPI:1740212232
Name:DOTTERS, DEBORAH J (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:J
Last Name:DOTTERS
Suffix:
Gender:F
Credentials: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 70368
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-0120
Mailing Address - Country:US
Mailing Address - Phone:541-465-3300
Mailing Address - Fax:541-683-1709
Practice Address - Street 1:3355 RIVERBEND DR
Practice Address - Street 2:STE 210
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-8800
Practice Address - Country:US
Practice Address - Phone:541-465-3300
Practice Address - Fax:541-683-1709
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD16053207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR079074Medicaid
ORC83559Medicare UPIN
OR102218Medicare ID - Type Unspecified