Organization · NPI-2

A.K. Gombart M.D.P.C

Family Medicine · Roseburg, OR

NPI number1013922996
StatusActive
Last updated in NPPESJun 13, 2008

Details

NPI
1013922996
Entity type
Organization (NPI-2)
Legal business name
A.K. Gombart M.D.P.C
Organization subpart
No
Enumeration date
Jul 29, 2006
Last updated
Jun 13, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicinemd08874ORYes

Practice location

532 W Umpqua St
Roseburg, OR 97470-2951

Phone 541-673-0133

Mailing address

532 W Umpqua St
Roseburg, OR 97470-2951

Phone 541-673-0133

Authorized official

Augustin Karl Gombart
Physician
5416730133

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