| Dr Randy Lee Moore, DO | |
|
2880 Nw Stewart Pkwy Ste 100, Roseburg, OR 97471-1201 | |
| (541) 673-2267 | |
| (541) 672-9483 |
| Full Name | Dr Randy Lee Moore |
|---|---|
| Gender | Male |
| Speciality | Radiology - Radiation Oncology |
| Location | 2880 Nw Stewart Pkwy Ste 100, Roseburg, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508813817 | NPI | - | NPPES |
| 026535 | Medicaid | OR | |
| P00332817 | Other | OR | RAILROAD MEDICARE |
| 16753 | Medicaid | ND | |
| 016146005 | Other | OR | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0001X | Radiology - Radiation Oncology | DO26902 (Oregon) | Primary |
| 2085R0203X | Radiology - Therapeutic Radiology | 28947 (Colorado) | Secondary |
| Entity Name | Bay Area Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225016561 PECOS PAC ID: 2163331000 Enrollment ID: O20040310000301 |
| Entity Name | Community Cancer Foundation |
|---|---|
| Entity Type | Part B Supplier - Radiation Therapy Center |
| Entity Identifiers | NPI Number: 1457351991 PECOS PAC ID: 1951345347 Enrollment ID: O20080625000338 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Randy Lee Moore, DO Po Box 833, Winchester, OR 97495-0833 Ph: (541) 673-2267 | Dr Randy Lee Moore, DO 2880 Nw Stewart Pkwy Ste 100, Roseburg, OR 97471-1201 Ph: (541) 673-2267 |
David G Seibel, DO Radiology Medicare: Not Enrolled in Medicare Practice Location: 2028 Fisher Rd, Roseburg, OR 97470 Phone: 541-673-7615 |
John Mccaffrey, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 913 Nw Garden Valley Blvd, Roseburg, OR 97470 Phone: 541-440-1000 |
Michael L Brown, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 2880 Nw Stewart Pkwy, Suite 100, Roseburg, OR 97471 Phone: 541-673-2267 |
Dr. Sylvia K Gosline, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 148 N River Dr, Roseburg, OR 97470 Phone: 541-672-5542 Fax: 541-672-7798 |
Jerry G Warren, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 621 Se Cass Ave, Suite 126, Roseburg, OR 97470 Phone: 541-580-0304 |
Kenneth L Linden, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 1887 W Harvard Ave, Roseburg, OR 97470 Phone: 541-673-4303 Fax: 541-440-9739 |
Michael Marietta, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2880 Nw Stewart Pkwy Ste 100, Roseburg, OR 97471 Phone: 541-673-2267 Fax: 541-672-9483 |