Provider Demographics
NPI:1013326362
Name:STEELHEAD SPECIALTY GROUP, PC
Entity type:Organization
Organization Name:STEELHEAD SPECIALTY GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-229-4070
Mailing Address - Street 1:2880 NW STEWART PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-1205
Mailing Address - Country:US
Mailing Address - Phone:541-229-4070
Mailing Address - Fax:541-229-4074
Practice Address - Street 1:2880 NW STEWART PKWY STE 300
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-1205
Practice Address - Country:US
Practice Address - Phone:541-229-4070
Practice Address - Fax:541-229-4074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty