Provider Demographics
NPI:1740465863
Name:EDWARD A. HELMAN
Entity type:Organization
Organization Name:EDWARD A. HELMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:HELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-770-5188
Mailing Address - Street 1:1017 ROYAL AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6127
Mailing Address - Country:US
Mailing Address - Phone:541-770-5188
Mailing Address - Fax:541-245-2506
Practice Address - Street 1:1017 ROYAL AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6127
Practice Address - Country:US
Practice Address - Phone:541-770-5188
Practice Address - Fax:541-245-2506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD09729207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR086637Medicaid
C92843Medicare UPIN
ORR0000WCJXTMedicare PIN