| NPI | 1063705887 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP SOUTH |
| Doing Business As | PMG MEDFORD PHYSIATRY |
| Doing Business As | PMG SOUTH MEDFORD NEUROLOGY |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Assistant Secretary Enrollments 425-358-9786 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2025-05-12 |