Mountain West Derm - Blackhart PLLC
Mountain West Derm - Blackhart PLLC is a Dermatology Physician in Roseburg, Oregon. Registered with an NPI since 2021.
- In the registry since
- 2021
What do these letters mean?
- PLLC — Professional limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
341 NW Medical Loop Ste 110Roseburg, OR 97471-5546
Phone: (541) 440-2165
Fax: (541) 440-8932
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dermatology Physician (primary) | Taxonomy 207N00000X |
|---|
Record details
| NPI number | 1891467577 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jeffrey Shackelton — Owner · (775) 283-4086 |
| NPI enumerated | October 1, 2021 |
| Last updated in NPPES | October 4, 2021 |
| Certification date | October 4, 2021 |
| Mailing address | 341 Nw Medical Loop Ste 110, Roseburg, OR 97471-5546 |
Other providers in Roseburg
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Jay N Gade, MDPHD
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Dr. Michael Heath, MD
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Jay N. Gade, MD, PHD, PC
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Julee Richards MD PC
341 Medical Loop Ste 110, Roseburg, OR 97471-5546 · (541) 440-2165
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Paul Douglas Reicherter, MD
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Dr. Julee K. Richards, MD
341 Medical Loop Ste 110, Roseburg, OR 97471-5546 · (541) 440-2165
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Kaylan Lawson Weese, MD
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