NPI | 1477881472 |
---|---|
Former Legal Business Name | PHOENIX MEDICAL GROUP OF MEDFORD |
Entity Type | Organization |
Authorized Contact | JEFFREY CHARLES OPPENHEIM Owner 856-231-7505 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2009-12-02 |
Last Update Date | 2009-12-02 |