Centennial Medical Group East, LLC
Centennial Medical Group East, LLC is a Family Medicine Physician in Myrtle Creek, Oregon. Licensed in Oregon. Registered with an NPI since 2013.
- Licensed in
- OR
- In the registry since
- 2013
- Specialties on file
- 3
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
145 NE Broadway StMyrtle Creek, OR 97457-9039
Phone: (541) 863-3146
Fax: (541) 863-3226
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Rural Health Clinic/Center (primary) | Taxonomy 261QR1300X (OR) |
|---|---|
| Family Medicine Physician | Taxonomy 207Q00000X · Licence 71216890 (OR) |
| Family Medicine Physician | Taxonomy 207Q00000X (OR) |
Record details
| NPI number | 1699103598 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Centennial Medical Group Dba Evergreen Family Medicine South |
| Authorized official | Kim Tyree — Coo · (541) 229-3332 |
| Other names | Evergreen Family Medicine South |
| NPI enumerated | October 31, 2013 |
| Last updated in NPPES | November 22, 2016 |
| Mailing address | 2801 Nw Mercy Dr, Suite 340, Roseburg, OR 97471-2348 |
Other providers in Myrtle Creek
-
Mark Michael Herscher, DO
145 NE Broadway, Myrtle Creek, OR 97457-0117 · (541) 863-3146
-
Dr. Jacqueline Marie Johnson, DO
145 NE Broadway St, Myrtle Creek, OR 97457-9039 · (541) 677-7200
-
Tom Lin, MD
145 NE Broadway St, Myrtle Creek, OR 97457-9039 · (541) 677-7200
-
Mark M Herscher DO
145 NE Broadway, Myrtle Creek, OR 97457-0117 · (541) 863-3146