Doctor Name: | MR. ROGER W GEORGE |
NPI Number: | 1912072539 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | NBC- HIS |
License Number: | HAS-P-429717 |
Business Practice Address: | 862 Lancaster Dr Se Salem, OR - 973015831 |
Business Phone Number: | 5033997501 |
Business Fax Number: | |
Mailing Address: | 41238 Manitau Rd Se, STAYTON |
State: | OR |
Postal Code: | 973839709 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | HAS-P-429717 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |