DR. MARK F. DEATHERAGE (NPI# 1841293156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841293156 |
| Entity Type | Individual |
| Full Name | DR. MARK F. DEATHERAGE |
| Credential | M.D. |
| Practice Address |
1600 Nw 6th St North Suite Grants Pass OR 97526-1094 |
| Practice Telephone | 5414745533 |
| Practice Fax Number | 5414762380 |
| Mailing Telephone | 5414745533 |
| Mailing Fax Number | 5414762380 |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2012-10-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MD11842 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 024059 | 05 |
| Street Address |
1600 NW 6TH ST NORTH SUITE |
| City | GRANTS PASS |
| State | OR |
| Zip Code | 97526-1094 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134567027 | Melissa M Greive | Surgery | 1600 Nw 6th St, Grants Pass, OR 97526-1094 | 2013-06-12 |
| 1235300062 | Paul Elvin Johnson Jr. | Otolaryngology | 1600 Nw 6th St, Grants Pass, OR 97526-1094 | 2008-03-19 |
| 1366572158 | Ear Nose and Throat Associates of Grants Pass PC | Otolaryngology | 1600 Nw 6th St, South Suite, Grants Pass, OR 97526-1094 | 2007-03-07 |
| 1326184607 | Wendell Charles Heidinger | Family Medicine | 1600 Nw 6th St, South Suite, Grants Pass, OR 97526-1094 | 2007-01-30 |
| 1235288986 | Linda Kay Schmitke | Speech-Language Pathologist | 1600 Nw 6th St, Grants Pass, OR 97526-1094 | 2007-01-10 |
| 1275533754 | Richard Cohen | Otolaryngology | 1600 Nw 6th St, Grants Pass, OR 97526-1094 | 2005-07-27 |
| 1700883956 | David Oehling | Surgery | 1600 Nw 6th St, Grants Pass, OR 97526-1094 | 2005-07-01 |
| 1467455774 | Cory Fawcett | Surgery | 1600 Nw 6th St, North Suite, Grants Pass, OR 97526-1094 | 2005-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205476777 | Kyla M Mccormick | Peer Specialist | 109 Nw Manzanita Avenue, Grants Pass, OR 97526 | 2020-01-13 |
| 1164076469 | Alicia Yvonne Hansen | Counselor | 1055 Clarey St., Grants Pass, OR 97526 | 2019-07-25 |
| 1841842598 | Michael Liam Reynolds, Dds, LLC | Dentist | 984 Ne 8th Street, Grants Pass Oregon, Grants Pass, OR 97526 | 2019-07-12 |
| 1881254746 | Brandi Mccrorey | Counselor | 418 Ne 6th Street, Suite 102, Grants Pass, OR 97526 | 2019-06-13 |
| 1700364502 | Premier Community Supports, LLC. | Day Training, Developmentally Disabled Services | 1439 Ne 6th St Ste C, Grants Pass, OR 97526 | 2018-08-02 |
| 1821584509 | Stefani Mcintyre | Massage Therapist | 1590 Se N Street, Warehouse #1574, Grants Pass, OR 97526 | 2018-07-06 |
| 1114467438 | Sandra P Martin | Chiropractor | 333 Sw 5th St. Suite B, Grants Pass, OR 97526 | 2017-03-06 |
| 1801347612 | Maci Wageman | Counselor | 1215 Sw G St Grants Pass Oregon 97526, Grants Pass, OR 97526 | 2016-10-17 |
| 1902353907 | Optimal Health of Southern Oregon, LLC | Family Medicine | 1600 Nw 6th St South Suite, Grants Pass, OR 97526 | 2016-09-07 |
| 1982150793 | Tanya White | Counselor | 402 Nw Fstreet, Grants Pass, OR 97526 | 2016-08-31 |
| Find all providers in zip 97526 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700883956 | David Oehling | Surgery | 1600 Nw 6th St, Grants Pass, OR 97526-1094 | 2005-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912334400 | Toshio Inahara | Surgery | 1115 Sw Summit View Dr, Portland, OR 97225-6197 | 2013-09-30 |
| 1902192396 | John Noel Dussel | Surgery | 9155 Sw Barnes Rd Ste 321, Portland, OR 97225 | 2011-06-23 |
| 1962791632 | Rishi Subbarayan | Surgery | 960 16th St, Springfield, OR 97477-4175 | 2011-04-04 |
| 1225351901 | Willamette Vascular Specialists, PC | Surgery | 1015 25th St Se, Salem, OR 97301 | 2010-03-09 |
| 1174756605 | Benjamin R. Wilson, Md, PC | Surgery | 700 Bellevue Street, Suite 240, Salem, OR 97301-3855 | 2009-09-01 |
| 1356584973 | Norina Mohd Nordin | Surgery | 9701 Sw Barnes Rd Ste 140, Portland, OR 97225-6688 | 2009-04-13 |
| 1992909766 | Wayne K. Nelson | Surgery | 1550 Ne 27th St Ste 100, Bend, OR 97701-7728 | 2007-06-13 |
| 1376753442 | Inovia LLC | Surgery | 2200 Ne Neff Rd Ste 204, Bend, OR 97701-4281 | 2007-05-23 |
| 1508074147 | Salem Vascular Consultants, LLP | Surgery | 1535 Liberty St Se, Salem, OR 97302-4345 | 2007-05-18 |
| 1750414330 | Robert J. Swangard, M.d., P.C. | Surgery | 655 E 11th Ave Ste 2a, Eugene, OR 97401-3683 | 2007-03-13 |
| Find all providers with the same taxonomy | ||||
| City | GRANTS PASS |
| Zip Code | 97526 |
Please comment or provide details below to improve the information on DR. MARK F. DEATHERAGE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.