Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Providence Health & Services - Oregon

Organization Internal Medicine Physician · NPI 1063705887

Providence Health & Services - Oregon is an Internal Medicine Physician in Medford, Oregon. Registered with an NPI since 2011.

In the registry since
2011
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Practice location Address checks out

920 Royal Ave
Medford, OR 97504-6169
Phone: (541) 732-8400
Fax: (541) 732-8401
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1063705887
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Health & Services - Oregon
Authorized official Donald Anderson — Assistant Secretary Enrollment · (425) 358-9786
Other names Pmg Medford Physiatry; Pmg Medford Physiatry; Pmg South Medford Neurology; Providence Medical Group South
NPI enumeratedMay 26, 2011
Last updated in NPPESNovember 19, 2025
Certification dateNovember 19, 2025
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

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