Organization · Type 2 NPI
Crater Lake Surgery Center LLC
Ambulatory Surgical Clinic/Center · Medford, OR
NPI number
1679939318
Active
Practice location
833 Bennett Ave
Medford, OR 97504-6715
Mailing address
825 Bennett Ave
Medford, OR 97504-6715
Other practice locations
- 835 Bennett Ave, Medford, OR 97504-6715 · (541) 779-5228
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ambulatory Surgical Clinic/Center Primary | 261QA1903X | None listed |
Ambulatory Surgical Clinic/Center: Definition to come...
Another provider at this address
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About NPI 1679939318
Crater Lake Surgery Center LLC's National Provider Identifier is 1679939318, issued on Jan 11, 2016. The primary taxonomy on file is Ambulatory Surgical Clinic/Center (261QA1903X), and the practice location is in Medford, OR. The record was last updated on Jun 18, 2018.