| Mid Valley Family Physicians | |
|
550 Dietz Ave Ne Keizer OR 97303-4615 | |
| (503) 393-0540 | |
| (503) 393-3695 |
| Full Name | Mid Valley Family Physicians |
|---|---|
| Speciality | Family Medicine |
| Location | 550 Dietz Ave Ne, Keizer, Oregon |
| Authorized Official Name and Position | Ronald M Palm (PHYSICIAN OWNER) |
| Authorized Official Contact | 5033930540 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid Valley Family Physicians 550 Dietz Ave Ne Keizer OR 97303-4615 Ph: (503) 393-0540 | Mid Valley Family Physicians 550 Dietz Ave Ne Keizer OR 97303-4615 Ph: (503) 393-0540 |
| NPI Number | 1225217995 |
|---|---|
| Provider Enumeration Date | 10/30/2007 |
| Last Update Date | 11/01/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225217995 | NPI | - | NPPES |
| 232446 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | D025302 (Oregon) | Primary |
| 207Q00000X | Family Medicine | D025292 (Oregon) | Secondary |
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