Centennial Medical Group West, LLC
Physician Assistant, Surgical in Roseburg, OR. Organization (NPI-2).
NPI number1063710192
StatusActive
Last updated in NPPESMar 15, 2011
Details
- NPI
- 1063710192
- Entity type
- Organization (NPI-2)
- Legal business name
- Centennial Medical Group West, LLC
- Organization subpart
- Yes
- Enumeration date
- Mar 15, 2011
- Last updated
- Mar 15, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | – | – | Yes |
Other names
- Centennial Surgical Assistants (Doing Business As)
Practice location
2700 Nw Stewart PkwyRoseburg, OR 97471-1281
Phone 541-677-2494 · Fax 541-677-2294
Mailing address
2801 Nw Mercy Dr Ste 340Roseburg, OR 97471-2348
Phone 541-677-2494 · Fax 541-677-2294
Authorized official
Rahul Agarwal
President
5416772494
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Surgical Physician Assistant providers in Roseburg, OR
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.