Centennial Medical Group East, LLC

NPI #1134436637 in Roseburg, Oregon

Provider Information

NPI Number: 1134436637
Entity Type: Organization
Organization Name: Centennial Medical Group East, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: CENTENNIAL MEDICAL GROUP, INC.
Primary Specialty: Family Medicine
Enumeration Date: Sep 3, 2010
Last Updated: Jul 1, 2025

Practice Location

Address: 2570 NW EDENBOWER BLVD
City: Roseburg
State: Oregon
ZIP Code: 97471-6214
Phone: (541) 677-2494

Authorized Official

Name: KIMBERLY TYREE
Title: COO
Phone: (541) 229-3332

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Emergency Medicine	207P00000X
Physician Assistant	363A00000X
Family Medicine	207Q00000X	Primary

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