| Mark M Herscher Do | |
|
145 Ne Broadway Myrtle Creek OR 97457-0117 | |
| (541) 863-3146 | |
| (541) 863-3226 |
| Full Name | Mark M Herscher Do |
|---|---|
| Speciality | Family Medicine |
| Location | 145 Ne Broadway, Myrtle Creek, Oregon |
| Authorized Official Name and Position | Cheryl Diane Herscher (OFFICE MANAGER) |
| Authorized Official Contact | 5418633146 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark M Herscher Do Po Box 789 Myrtle Creek OR 97457-0117 Ph: (541) 863-3146 | Mark M Herscher Do 145 Ne Broadway Myrtle Creek OR 97457-0117 Ph: (541) 863-3146 |
| NPI Number | 1316125784 |
|---|---|
| Provider Enumeration Date | 02/07/2008 |
| Last Update Date | 04/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316125784 | NPI | - | NPPES |
| 138784 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | DO14354 (Oregon) | Primary |
Centennial Medical Group East, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 145 Ne Broadway St, Myrtle Creek, OR 97457 Phone: 541-863-3146 Fax: 541-863-3226 |