1821257346 NPI number — NATURAL ORTHOPEDIC & INTERNAL MEDICINE

Table of content: (NPI 1821257346)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821257346 NPI number — NATURAL ORTHOPEDIC & INTERNAL MEDICINE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATURAL ORTHOPEDIC & INTERNAL MEDICINE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NATURAL PHYSICIANS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821257346
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/10/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4353
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALEM
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97302-8353
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-363-6868
Provider Business Mailing Address Fax Number:
503-779-1053

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4555 LIBERTY RD S
Provider Second Line Business Practice Location Address:
SUITE 360
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97302-5093
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-363-6868
Provider Business Practice Location Address Fax Number:
503-779-1053
Provider Enumeration Date:
06/09/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MILROY
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
A
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
503-363-6868

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  273128 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 175F00000X , with the licence number: 1188 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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