| Rod Todd MD PC | |
|
2282 Nw Troost St Ste 103 Roseburg OR 97471-6072 | |
| (541) 672-0497 | |
| (541) 957-2663 |
| Full Name | Rod Todd MD PC |
|---|---|
| Speciality | Family Medicine |
| Location | 2282 Nw Troost St Ste 103, Roseburg, Oregon |
| Authorized Official Name and Position | Rodney Todd (PRESIDENT) |
| Authorized Official Contact | 5416720497 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rod Todd MD PC 2282 Nw Troost St Ste 103 Roseburg OR 97471-6072 Ph: (541) 672-0497 | Rod Todd MD PC 2282 Nw Troost St Ste 103 Roseburg OR 97471-6072 Ph: (541) 672-0497 |
| NPI Number | 1720327810 |
|---|---|
| Provider Enumeration Date | 02/08/2013 |
| Last Update Date | 02/08/2013 |
| Medicare PECOS PAC ID | 1759529118 |
|---|---|
| Medicare Enrollment ID | O20130524000654 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720327810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD25765 (Oregon) | Primary |
| Provider Name | Candace M Hatton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023081528 PECOS PAC ID: 8921024415 Enrollment ID: I20051024000848 |
| Provider Name | Aimee F Hansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376527788 PECOS PAC ID: 5092972778 Enrollment ID: I20120208000309 |
| Provider Name | Rodney Earl Todd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629085907 PECOS PAC ID: 4486892841 Enrollment ID: I20130524000656 |
| Provider Name | Kiersten Sperry |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003184714 PECOS PAC ID: 6800218082 Enrollment ID: I20200616001968 |
| Provider Name | Amanda Garner |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1043823792 PECOS PAC ID: 6800298852 Enrollment ID: I20210713002239 |
| Provider Name | Bailey Wynn Gibbs |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033891387 PECOS PAC ID: 2860926227 Enrollment ID: I20241108000251 |
| Provider Name | Tyler Duane Wood |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1861217960 PECOS PAC ID: 8820527021 Enrollment ID: I20250131002160 |
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