Ashland Family Practice LLC

Organization Active NPI Family Medicine Physician · Ashland, OR

NPI 1740787456 · NPPES record last updated Jan 18, 2024

Key facts

NPI
1740787456
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
ASHLAND FAMILY PRACTICE LLC
Practice address
935 Siskiyou Blvd
Ashland, OR 97520
Phone
(541) 482-2716
Fax
(541) 488-5461
NPI assigned
Apr 9, 2018
Organization subpart
No

Authorized official

Name
Cynthia A Parks
Title
Provider
Phone
(541) 482-2716

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20180702001336 OR Part B Supplier - Clinic/Group Practice 6305192543 Receives reassigned benefits from 4 practitioners
Practice locations: Ashland, OR

National Provider Directory

Locations

935 Siskiyou Blvd
Ashland, OR 97520
Phone (541) 482-2716

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

935 Siskiyou Blvd
Ashland, OR 97520

Mailing address

935 Siskiyou Blvd
Ashland, OR 97520-2143

Other providers in Ashland, OR

All providers in Ashland, OR · Family Medicine Physician in Oregon

Sources for this page

Verify at the official NPI Registry.