| Applegate Medical Associates - East | |
|
689 E 19th Ave Eugene OR 97401-4304 | |
| (541) 868-1876 | |
| (541) 868-0932 |
| Full Name | Applegate Medical Associates - East |
|---|---|
| Speciality | Clinic/Center |
| Location | 689 E 19th Ave, Eugene, Oregon |
| Authorized Official Name and Position | John V Allcott (OWNER) |
| Authorized Official Contact | 5418681876 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Applegate Medical Associates - East 689 E 19th Ave Eugene OR 97401-4304 Ph: (541) 868-1876 | Applegate Medical Associates - East 689 E 19th Ave Eugene OR 97401-4304 Ph: (541) 868-1876 |
| NPI Number | 1417035031 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 10/09/2018 |
| Medicare PECOS PAC ID | 5799773503 |
|---|---|
| Medicare Enrollment ID | O20040503000077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417035031 | NPI | - | NPPES |
| 222810 | Medicaid | OR | |
| 230482 | Medicaid | OR | |
| 071324 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | MD08934 (Oregon) | Secondary |
| 261Q00000X | Clinic/center | MD11435 (Oregon) | Primary |
| 261Q00000X | Clinic/center | MD16571 (Oregon) | Secondary |
| Provider Name | Henry I Elder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356403455 PECOS PAC ID: 1052384906 Enrollment ID: I20040818000494 |
| Provider Name | John V Allcott |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871658153 PECOS PAC ID: 0345250965 Enrollment ID: I20101005000050 |
| Provider Name | Philip D Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417990045 PECOS PAC ID: 1850280751 Enrollment ID: I20150831002502 |
| Provider Name | Camm Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699118935 PECOS PAC ID: 9032485446 Enrollment ID: I20171030000834 |
| Provider Name | Elizabeth Jean Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992085310 PECOS PAC ID: 6406004324 Enrollment ID: I20210405001605 |
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David A. Bove, Nd Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1161 Lincoln St, Eugene, OR 97401 Phone: 541-683-2126 | |
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