Roseburg Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD18437 Issued in OR

Legal business name

ROSEBURG FAMILY MEDICINE

Practice address

340 NW Medical Loop
Roseburg, OR 97471-1645

Phone

(541) 677-6599

Fax

(541) 677-6576

NPI assigned

May 1, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Clyde A Keys, M.D.

Title

Owner

Phone

(541) 677-6599

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419897600000",
    "number": "1447471990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 NW MEDICAL LOOP",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711645",
            "telephone_number": "541-677-6599",
            "fax_number": "541-677-6576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 NW MEDICAL LOOP",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711645",
            "telephone_number": "541-677-6599",
            "fax_number": "541-677-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSEBURG FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2014-12-30",
        "status": "A",
        "authorized_official_last_name": "KEYS",
        "authorized_official_first_name": "CLYDE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-677-6599",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD18437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDENTIFICATION NUMBER",
            "identifier": "R0000WCYBS",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roseburg Clinic, P.C.
• Roseburg Clinic, P.C.
• Roseburg Counseling & Wellness
• Roseburg Douglas Associates
• Roseburg Family Dental Care
• Roseburg Foot & Ankle Specialists, P.C.
• Roseburg Heart Associates PC
• Roseburg Massage Health & Beauty Spa, LLC
• Roseburg Oncology PC
• Roseburg Radiologists P C

• Family Medicine Physician in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.