Provider Demographics
NPI:1821032350
Name:SCHAFFER, RODNEY WARNER (MD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:WARNER
Last Name:SCHAFFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E 2ND AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2452
Mailing Address - Country:US
Mailing Address - Phone:541-484-9229
Mailing Address - Fax:541-485-3602
Practice Address - Street 1:400 E 2ND AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2452
Practice Address - Country:US
Practice Address - Phone:541-484-9229
Practice Address - Fax:541-485-3602
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD16442207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR008537Medicaid
OR0000BKDGKMedicare ID - Type Unspecified
OR008537Medicaid