Provider Demographics
NPI:1932467008
Name:MAXWELL C. FURR, M.D. LLC
Entity Type:Organization
Organization Name:MAXWELL C. FURR, M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MAXWELL
Authorized Official - Middle Name:C
Authorized Official - Last Name:FURR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-222-3638
Mailing Address - Street 1:2222 NW LOVEJOY ST
Mailing Address - Street 2:STE 607
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-3033
Mailing Address - Country:US
Mailing Address - Phone:503-222-3638
Mailing Address - Fax:503-223-5139
Practice Address - Street 1:2222 NW LOVEJOY ST
Practice Address - Street 2:STE 607
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3033
Practice Address - Country:US
Practice Address - Phone:503-222-3638
Practice Address - Fax:503-223-5139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA116392174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty