Individual provider · Type 1 NPI

Matthew T. Stark, PA-C.

Medical Physician Assistant · Roseburg, OR

NPI number 1174700934 Active

Practice location

1937 W Harvard Ave
Roseburg, OR 97471-2720

Call (541) 677-7200 Map

Fax (541) 229-3309

Mailing address

2570 NW Edenbower Blvd Ste 100
Roseburg, OR 97471-6214

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700XNone listed
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1174700934

Matthew T. Stark, PA-C.'s National Provider Identifier is 1174700934, issued on Jan 23, 2008. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Roseburg, OR. The record was last updated on Jun 11, 2020.