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MID-COLUMBIA MEDICAL CENTER NPI 1164735478


NPI Information

NPI: 1164735478
Provider Name: MID-COLUMBIA MEDICAL CENTER

Doing Business As: GORGE UROLOGY

Classification: Urology - 208800000X
Entity Type: Organization
Address:
1805 E 19TH ST
THE DALLES, OR
ZIP 97058
Phone: (541) 296-2201
Get Directions

MID-COLUMBIA MEDICAL CENTER is an urology in The Dalles, OR. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. MID-COLUMBIA MEDICAL CENTER NPI is 1164735478. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Gorge Urology.

The provider's business location address is:

1805 E 19TH ST
THE DALLES, OR
ZIP 97058-000
Phone: (541) 296-2201
Fax: (541) 296-1237

The provider's authorized official is Dennis Knox .
The authorized official title is Corporate Officer and has the following contact phone number (541) 296-7273.

The enumeration date for this NPI number is 7/16/2010 and was last updated on 6/16/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208800000XUrologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1500630716MEDICAIDOREGON
22008645MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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