Centennial Medical Group East, LLC
NPI #1699103598 in Myrtle Creek, Oregon
Provider Information
- NPI Number
- 1699103598
- Entity Type
- Organization
- Organization Name
- Centennial Medical Group East, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- CENTENNIAL MEDICAL GROUP DBA EVERGREEN FAMILY MEDICINE SOUTH
- Primary Specialty
- Clinic/Center - Rural Health
- Enumeration Date
- Oct 31, 2013
- Last Updated
- Nov 22, 2016
Practice Location
- Address
- 145 NE BROADWAY ST
- City
- Myrtle Creek
- State
- Oregon
- ZIP Code
- 97457-9039
- Phone
- (541) 863-3146
Authorized Official
- Name
- KIM TYREE
- Title
- COO
- Phone
- (541) 229-3332
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
| Clinic/Center - Rural Health — Rural Health |
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