Centennial Medical Group East, LLC

NPI #1164124111 in Sutherlin, Oregon

Provider Information

NPI Number: 1164124111
Entity Type: Organization
Organization Name: Centennial Medical Group East, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: CENTENNIAL MEDICAL GROUP EAST, LLC
Primary Specialty: Family Medicine
Enumeration Date: Mar 21, 2023
Last Updated: Mar 21, 2023

Practice Location

Address: 249 DAKOTA ST
City: Sutherlin
State: Oregon
ZIP Code: 97479-9908
Phone: (541) 677-7200

Authorized Official

Name: KIMBERLY TYREE
Title: CHIEF OPERATING OFFICER
Phone: (541) 229-3332

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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