Pacific Plastic Surgery PC
Clinic/Center, Ambulatory Surgical in Eugene, OR. Organization (NPI-2).
NPI number1659331007
StatusActive
Last updated in NPPESOct 19, 2009
Details
- NPI
- 1659331007
- Entity type
- Organization (NPI-2)
- Legal business name
- Pacific Plastic Surgery PC
- Organization subpart
- No
- Enumeration date
- Mar 27, 2006
- Last updated
- Oct 19, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QA1903X | Clinic/Center, Ambulatory Surgical | MD13772 | OR | Yes |
Practice location
743 Country Club RdEugene, OR 97401-6019
Phone 541-683-0878 · Fax 541-683-5206
Mailing address
743 Country Club RdEugene, OR 97401-6019
Phone 541-683-0878 · Fax 541-683-5206
Authorized official
Lois M Fondren
Manager
5416830878
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