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

Siskiyou Vital Medicine LLC

Organization Family Medicine Physician · NPI 1407442338

Siskiyou Vital Medicine LLC is a Family Medicine Physician in Medford, Oregon. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
5
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

940 Ellendale Dr # 102
Medford, OR 97504-8216
Phone: (541) 210-5687
Fax: (541) 392-4962
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X
Family Medicine Physician Taxonomy 207Q00000X
Community Health Clinic/Center Taxonomy 261QC1500X
Infusion Therapy Clinic/Center Taxonomy 261QI0500X
Multi-Specialty Clinic/Center Taxonomy 261QM1300X

Record details

NPI number1407442338
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gregory Duncan — Owner/Member · (541) 210-5687
NPI enumeratedDecember 15, 2020
Last updated in NPPESDecember 15, 2020
Certification dateDecember 15, 2020
Mailing address940 Ellendale Dr # 102, Medford, OR 97504-8216

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