Provider Demographics
NPI:1881639995
Name:REHABILITATION MEDICINE PHYSICIANS OF SOUTHERN OREGON, P.C.
Entity Type:Organization
Organization Name:REHABILITATION MEDICINE PHYSICIANS OF SOUTHERN OREGON, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:ZASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-776-5065
Mailing Address - Street 1:2780 E BARNETT RD
Mailing Address - Street 2:#320
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8674
Mailing Address - Country:US
Mailing Address - Phone:541-776-5065
Mailing Address - Fax:541-776-5171
Practice Address - Street 1:2780 E BARNETT RD
Practice Address - Street 2:#320
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8674
Practice Address - Country:US
Practice Address - Phone:541-776-5065
Practice Address - Fax:541-776-5171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORN/A204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR0000WCJCDMedicare UPIN