Provider Demographics
NPI:1891112967
Name:ROBERT A. MAIRS DO PC
Entity Type:Organization
Organization Name:ROBERT A. MAIRS DO PC
Other - Org Name:TREASURE VALLEY WOMEN AND FAMILY MEDICINE CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAIRS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:541-889-2229
Mailing Address - Street 1:1219 SW 4TH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-4566
Mailing Address - Country:US
Mailing Address - Phone:541-889-2229
Mailing Address - Fax:541-889-0716
Practice Address - Street 1:1219 SW 4TH AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-4566
Practice Address - Country:US
Practice Address - Phone:541-889-2229
Practice Address - Fax:541-889-0716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health