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

Southern Oregon Ear Nose & Throat P C

Organization Facial Plastic Surgery Physician · NPI 1821274317

Southern Oregon Ear Nose & Throat P C is a Facial Plastic Surgery Physician in Medford, Oregon. Licensed in Oregon. Registered with an NPI since 2008.

Licensed in
OR
In the registry since
2008

Practice location Address checks out

555 Black Oak Dr Ste 210
Medford, OR 97504-8491
Phone: (541) 734-3540
Show map & directions

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

Specialties & licences

Facial Plastic Surgery Physician (primary) Taxonomy 207YS0123X · Licence MD17390 (OR)

Record details

NPI number1821274317
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cindi Boucher — Office Manager · (541) 734-3610
NPI enumeratedJanuary 14, 2008
Last updated in NPPESMarch 10, 2022
Certification dateMarch 10, 2022
Mailing address555 Black Oak Dr Ste 210, Medford, OR 97504-8491