Provider Demographics
NPI:1174572317
Name:OVERLAND, ORDAL, & THORSON PULMONARY CONSULTANTS PC
Entity type:Organization
Organization Name:OVERLAND, ORDAL, & THORSON PULMONARY CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SALVATTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-494-2020
Mailing Address - Street 1:555 BLACK OAK DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8447
Mailing Address - Country:US
Mailing Address - Phone:541-494-2000
Mailing Address - Fax:541-494-2002
Practice Address - Street 1:555 BLACK OAK DR
Practice Address - Street 2:SUITE 300
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8447
Practice Address - Country:US
Practice Address - Phone:541-494-2000
Practice Address - Fax:541-494-2002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-06
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OROOOOWCJGJMedicare ID - Type UnspecifiedGROUP NUMBER