Southern Oregon Ear Nose & Throat P C

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

MD17390 Issued in OR

Legal business name

SOUTHERN OREGON EAR NOSE & THROAT P C

Practice address

555 Black Oak Dr Ste 210
Medford, OR 97504-8491

Phone

(541) 734-3540

NPI assigned

Jan 14, 2008

Last updated

Mar 10, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Cindi S Boucher

Title

Office Manager

Phone

(541) 734-3610

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel Mac Dowell Wayman, MD

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Medford, OR
  • NPI 1952476350
  NPD

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646870400000",
    "number": "1821274317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 BLACK OAK DR STE 210",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048491",
            "telephone_number": "541-734-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 BLACK OAK DR STE 210",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048491",
            "telephone_number": "541-734-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OREGON EAR NOSE & THROAT P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-14",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A",
        "authorized_official_last_name": "BOUCHER",
        "authorized_official_first_name": "CINDI",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "541-734-3610",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "OR",
            "license": "MD17390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Oregon Cardiology LLC
• Southern Oregon Childrens Clinic
• Southern Oregon Chiropractic, LLC (Southern Oregon Acupuncture)
• Southern Oregon Denture & Dental
• Southern Oregon Direct Primary Care LLC
• Southern Oregon Education Service District
• Southern Oregon Education Service District
• Southern Oregon Education Service District
• Southern Oregon Endodontics, PC
• Southern Oregon Float Spa, LLC

• Facial Plastic Surgery Physician in Medford, OR
• Providers in Medford, OR by specialty
• Facial Plastic Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.