Provider Demographics
NPI:1174537328
Name:STRICKLAND, HEATHER D (MD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:D
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1322 E MCANDREWS RD
Mailing Address - Street 2:STE 202
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6177
Mailing Address - Country:US
Mailing Address - Phone:541-773-3688
Mailing Address - Fax:541-773-3125
Practice Address - Street 1:1322 E MCANDREWS RD
Practice Address - Street 2:STE 202
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6177
Practice Address - Country:US
Practice Address - Phone:541-773-3688
Practice Address - Fax:541-773-3125
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD17955208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR46529Medicaid
ORF54521Medicare UPIN
OR46529Medicaid