SOUTHERN OREGON NEUROSURGICAL & SPINE ASSOCIATES, PC (NPI# 1912288671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912288671 |
| Entity Type | Organization |
| Organization Name | SOUTHERN OREGON NEUROSURGICAL & SPINE ASSOCIATES, PC |
| Practice Address |
2900 State St Medford OR 97504-8475 |
| Practice Telephone | 5417791672 |
| Practice Fax Number | 5417790986 |
| Mailing Telephone | 5417791672 |
| Mailing Fax Number | 5417790986 |
| Enumeration Date | 2011-09-07 |
| Last Update Date | 2011-09-15 |
| Authorized Official Name | DR. MIROSLAV BOBEK (PHYSICIAN) |
| Authorized Official Telephone | 5417791672 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SOUTHERN OREGON NEUROSURGICAL & SPINE ASSOCIATES, PC | 2900 State St, Medford, OR 97504 |
| Street Address |
2900 STATE ST |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-8475 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881693133 | Miroslav Patrick Bobek | Neurological Surgery | 2900 State St, Medford, OR 97504-8475 | 2005-07-19 |
| 1437762333 | Nicole Elisa Gregoire | Physician Assistant | 2900 State St, Medford, OR 97504-8458 | 2020-08-28 |
| 1033636279 | Kaitlin Eileen Stapleton | Nurse Practitioner | 2900 State St, Medford, OR 97504-8458 | 2017-08-28 |
| 1982066171 | App Neurology Clinic | Neuromusculoskeletal Medicine & OMM | 2900 State St, Suite 101, Medford, OR 97504-8475 | 2016-03-25 |
| 1093193831 | Dakota Shawn Doke | Physician Assistant | 2900 State St, Medford, OR 97504-8458 | 2015-05-13 |
| 1982953113 | Sarah L Crawford | Nurse Practitioner | 2900 State St, Medford, OR 97504-8475 | 2012-09-04 |
| 1225349772 | Raquel F Spaulding | Physician Assistant | 2900 State St, Medford, OR 97504-8458 | 2010-06-30 |
| 1760662720 | Timothy David Uschold | Neurological Surgery | 2900 State St, Medford, OR 97504-8475 | 2007-11-07 |
| 1568672715 | Anna L Uschold | Physician Assistant | 2900 State St, Medford, OR 97504-8475 | 2007-05-23 |
| 1023102159 | Matthew Louis Miller | Neurological Surgery | 2900 State St, Medford, OR 97504-8475 | 2006-10-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881693133 | Miroslav Patrick Bobek | Neurological Surgery | 2900 State St, Medford, OR 97504-8475 | 2005-07-19 |
| 1366623738 | Thomas Purtzer | Neurological Surgery | 1322 E Mcandrews Rd, Ste 101, Medford, OR 97504-6177 | 2007-11-14 |
| 1760662720 | Timothy David Uschold | Neurological Surgery | 2900 State St, Medford, OR 97504-8475 | 2007-11-07 |
| 1023102159 | Matthew Louis Miller | Neurological Surgery | 2900 State St, Medford, OR 97504-8475 | 2006-10-03 |
| 1063414803 | David Howard Walker | Neurological Surgery | 2900 State St, Medford, OR 97504-8475 | 2005-08-11 |
| 1831199074 | Jeffrey Allen Louie | Neurological Surgery | 2900 State St, Medford, OR 97504-8475 | 2005-07-29 |
| 1477553618 | Donald Andrew Ross | Neurological Surgery | 2900 State St, Medford, OR 97504-8475 | 2005-07-29 |
| 1336149954 | Medford Neuro Clinic Inc | Neurological Surgery | 2900 State St, Medford, OR 97504-8475 | 2005-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063909737 | Norwyn Robert Newby | Neurological Surgery | 3054 Nw Duffy Dr, Bend, OR 97703-5485 | 2018-04-18 |
| 1447764485 | Columbia Neurosurgical Trauma, LLC | Neurological Surgery | 1040 Nw 22nd Ave Ste 630, Portland, OR 97210-3041 | 2017-11-29 |
| 1194178590 | Philippe Magown | Neurological Surgery | 3303 Sw Bond Ave # Ch8n, Department of Neurological Surgery, Ohsu, Portland, OR 97239-4501 | 2016-07-20 |
| 1922475813 | Willliam Leonard Debolt | Neurological Surgery | 7419 Nw Cornell Rd, Portland, OR 97229-6901 | 2015-08-26 |
| 1285040436 | Berk Neurosurgical LLC | Neurological Surgery | 501 N Graham St Ste 500, Portland, OR 97227 | 2014-07-09 |
| 1366860009 | Kathryn Wagner | Neurological Surgery | 3101 Sw 13th Ave Apt 19, Portland, OR 97239-3071 | 2014-03-31 |
| 1033451265 | Greater Portland Neurosurgical Center, PC | Neurological Surgery | 24900 Se Stark St Ste 209, Gresham, OR 97030-3382 | 2013-03-26 |
| 1699038323 | James Steve Heiden | Neurological Surgery | 2496 Nw 141st Pl, Portland, OR 97229-7078 | 2012-06-18 |
| 1467725713 | Gerard Joseph Voelkers Jr. | Neurological Surgery | 130 S Drift Creek Camp Rd, Lincoln City, OR 97367-9768 | 2012-02-17 |
| 1942578026 | Nw Neurosurgery LLC | Neurological Surgery | 311 Nw 12th Ave Unit 1003, Portland, OR 97209-2995 | 2011-12-05 |
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| 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.