| Lance Gregory Loberg, MD | |
|
9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | |
| (503) 879-2002 | |
| Not Available |
| Full Name | Lance Gregory Loberg |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 46 Years |
| Location | 9605 Grand Ronde Rd, Grand Ronde, Oregon |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932180734 | NPI | - | NPPES |
| 023015 | Medicaid | OR | |
| 267195 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD13309 (Oregon) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Healthy Living At Home - Salem | Mcminnville, OR | Home health agency |
| Willamette Valley Medical Center | Mcminnville, OR | Hospital |
| West Valley Hospital | Dallas, OR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Confederated Tribes Of The Grand Ronde Community Of Oregon | 6103717277 | 12 |
| Entity Name | Confederated Tribes Of The Grand Ronde Community Of Oregon |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174666358 PECOS PAC ID: 6103717277 Enrollment ID: O20040320000494 |
| Mailing Address | Practice Location Address |
|---|---|
| Lance Gregory Loberg, MD 1002 Bellevue St Se, Salem, OR 97301-4006 Ph: (503) 561-5554 | Lance Gregory Loberg, MD 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 Ph: (503) 879-2002 |
Carolyn S Fairfax, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 9605 Grand Ronde Rd, Grand Ronde, OR 97347 Phone: 503-879-2002 Fax: 503-879-2071 | |
Brianna Wing, NP, RN Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 9605 Grand Ronde Rd, Grand Ronde, OR 97347 Phone: 503-879-2002 | |
Randall E Blome, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 9605 Grand Ronde Rd, Grand Ronde, OR 97347 Phone: 503-879-2002 Fax: 503-879-2015 |