Centennial Medical Group West, LLC

NPI #1245547744 in Roseburg, Oregon

Provider Information

NPI Number: 1245547744
Entity Type: Organization
Organization Name: Centennial Medical Group West, LLC
Primary Specialty: Ophthalmology
Enumeration Date: Sep 3, 2010
Last Updated: Mar 7, 2017

Practice Location

Address: 2801 NW MERCY DR.
Address 2: STE. 340
City: Roseburg
State: Oregon
ZIP Code: 97471
Phone: (541) 677-4319

Authorized Official

Name: DOUGLAS KLEBE
Title: OFFICER
Phone: (541) 677-3650

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X	Primary

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