| Organization Name: | ROSEBURG CLINIC PC |
| NPI Number: | 1023094307 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DELL G GRAY (CEO) |
| Mailing Address: | 2750 W Harvard Ave Roseburg |
| State: | OR US |
| Postal Code: | 974712608 |
| Phone Number: | 5416738988 |
| Fax Number: | 5416728103 |
| NPI Enumeration Date: | 12/19/2005 |
| NPI Last Update Date: | 10/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |