Full Name | |
---|---|
Speciality | Family Medicine |
Location | 525 North Barnes, Seneca, Oregon |
Authorized Official Name and Position | Thomas M Fitzpatrick (SOLE MEMBER) |
Authorized Official Contact | 5415737988 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
73216 Foley Rd Burns OR 97720-9303 Ph: (541) 573-7988 | 525 North Barnes Seneca OR 97873 Ph: (541) 542-2222 |
NPI Number | 1790910115 |
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Provider Enumeration Date | 05/29/2009 |
Last Update Date | 06/28/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790910115 | NPI | - | NPPES |
R147670 | Other | OR | PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | MD16856 (Oregon) | Primary |