Provider Demographics
NPI:1992836522
Name:REHABILITATION MEDICINE ASSOCIATES OF EUGENE-SPRINGFIELD PC
Entity Type:Organization
Organization Name:REHABILITATION MEDICINE ASSOCIATES OF EUGENE-SPRINGFIELD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:WELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-683-4242
Mailing Address - Street 1:242 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2477
Mailing Address - Country:US
Mailing Address - Phone:541-683-4242
Mailing Address - Fax:541-343-5078
Practice Address - Street 1:242 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2477
Practice Address - Country:US
Practice Address - Phone:541-683-4242
Practice Address - Fax:541-343-5078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR118504Medicare PIN
ORR025WCHCGHMedicare PIN
ORR025WCHCGFMedicare PIN
ORR0000WCHCGMedicare PIN
ORR00WCHCGHMedicare PIN
ORR025WCHCGBMedicare PIN