| Chiloquin Family Practice Inc Pc | |
|
2825 Ranch Rd Chiloquin OR 97624-5749 | |
| (541) 783-3412 | |
| (541) 783-3412 |
| Full Name | Chiloquin Family Practice Inc Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2825 Ranch Rd, Chiloquin, Oregon |
| Authorized Official Name and Position | Lawrence Lee Cohen (OWNER) |
| Authorized Official Contact | 5417833412 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chiloquin Family Practice Inc Pc Po Box 331 Chiloquin OR 97624-0331 Ph: (541) 783-3412 | Chiloquin Family Practice Inc Pc 2825 Ranch Rd Chiloquin OR 97624-5749 Ph: (541) 783-3412 |
| NPI Number | 1053545590 |
|---|---|
| Provider Enumeration Date | 05/13/2009 |
| Last Update Date | 05/13/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053545590 | NPI | - | NPPES |
| 287928 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD18099 (Oregon) | Primary |
Klamath Health Partnership Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Wasco Ave, Chiloquin, OR 97624 Phone: 541-783-2292 Fax: 541-783-3160 | |
Klamath Tribal Health & Family Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 Chiloquin Boulevard, Chiloquin, OR 97624 Phone: 541-783-2438 Fax: 541-783-3554 | |
Klamath Tribal Health & Family Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 330 Chiloquin Blvd, Chiloquin, OR 97624 Phone: 541-783-2438 Fax: 541-783-3273 |