| Sally Suzanne Marie MD LLC | |
|
1755 Coburg Rd Ste 5 Eugene OR 97401-4982 | |
| (541) 654-4175 | |
| Not Available |
| Full Name | Sally Suzanne Marie MD LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 1755 Coburg Rd Ste 5, Eugene, Oregon |
| Authorized Official Name and Position | Sally Suzanne Marie (OWNER/PHYSICIAN) |
| Authorized Official Contact | 5416544175 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sally Suzanne Marie MD LLC 1755 Coburg Rd Ste 5 Eugene OR 97401-4982 | Sally Suzanne Marie MD LLC 1755 Coburg Rd Ste 5 Eugene OR 97401-4982 Ph: (541) 654-4175 |
| NPI Number | 1184881393 |
|---|---|
| Provider Enumeration Date | 05/16/2008 |
| Last Update Date | 11/23/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184881393 | NPI | - | NPPES |
| 142976 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 14482 (Oregon) | Primary |
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