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

Providence Health & Services - Oregon

Organization Family Medicine Physician · NPI 1992031595

Providence Health & Services - Oregon is a Family Medicine Physician in Eagle Point, Oregon. Registered with an NPI since 2009.

In the registry since
2009
Specialties on file
5

Practice location Address checks out

1332 S Shasta Ave Ste A
Eagle Point, OR 97524-8623
Phone: (541) 826-8160
Fax: (541) 826-8197
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Pediatrics Physician Taxonomy 208000000X
Child & Adolescent Psychiatry Physician Taxonomy 2084P0804X
Geriatric Psychiatry Physician Taxonomy 2084P0805X
Multi-Specialty Clinic/Center Taxonomy 261QM1300X

Record details

NPI number1992031595
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Health & Services - Oregon
Authorized official Donald Anderson — Assistant Secretary Enrollment · (425) 358-9786
Other names Pmg South Eagle Point; Pmg South Eagle Point; Providence Medical Group South
NPI enumeratedNovember 2, 2009
Last updated in NPPESNovember 19, 2025
Certification dateNovember 19, 2025
Mailing addressPo Box 31001 - 4180, Pasadena, CA 91110-4180

Other providers in Eagle Point