DR. LAURIE DUTKIEWICZ (NPI# 1952514143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952514143 |
| Entity Type | Individual |
| Full Name | DR. LAURIE DUTKIEWICZ |
| Credential | D.O |
| Practice Address |
965 Ellendale Dr Medford OR 97504-8215 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5417343430 |
| Practice Fax Number | 5417343638 |
| Mailing Telephone | 5417343430 |
| Mailing Fax Number | 5417343638 |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-09-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | DO153852 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500637941 | 05 |
| Street Address |
965 ELLENDALE DR |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-8215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184621559 | Todd A. Winter | Internal Medicine | 965 Ellendale Dr, Medford, OR 97504-8215 | 2005-06-30 |
| 1548818180 | Lindsey A Patterson | Dietitian, Registered | 965 Ellendale Dr, Medford, OR 97504-8215 | 2019-08-27 |
| 1275035164 | Tanya M Haight | Occupational Therapist | 965 Ellendale Dr, Medford, OR 97504-8215 | 2018-03-06 |
| 1578064416 | Garett S Clayton | Physical Therapist | 965 Ellendale Dr, Medford, OR 97504-8215 | 2018-02-26 |
| 1780184325 | Jamie K Montgomery | Physical Therapist | 965 Ellendale Dr, Medford, OR 97504-8215 | 2018-02-20 |
| 1700386067 | Brian Saling | Physical Therapist | 965 Ellendale Dr, Medford, OR 97504-8215 | 2018-02-13 |
| 1629466800 | Bruce K Lawrence | Physical Therapist | 965 Ellendale Dr, Medford, OR 97504 | 2014-12-23 |
| 1730432378 | Eric Lynn Wickard | Physical Therapist | 965 Ellendale Dr, Medford, OR 97504-8215 | 2012-10-19 |
| 1093850919 | Terrace R Mucha | Family Medicine | 965 Ellendale Dr, Medford, OR 97504-8215 | 2007-02-20 |
| 1427190594 | Diana L Bowman | Physician Assistant | 965 Ellendale Dr, Medford, OR 97504-8215 | 2007-02-13 |
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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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932679297 | Southern Oregon Medical Clinic LLC | Internal Medicine | 537 Murphy Rd Ste B, Medford, OR 97504-8187 | 2018-11-29 |
| 1043714876 | Winchester Wound Care Specialists Pllc | Internal Medicine | 75 Riverside Ave Ste 4, Medford, MA 02155-4600 | 2018-03-19 |
| 1124387600 | John Retzlaff | Internal Medicine | 6959 Pineridge Dr, Medford, OR 97504-9234 | 2012-05-03 |
| 1144511643 | John Michael Malleis | Internal Medicine | 2859 State St Ste 102, Medford, OR 97504-8495 | 2011-05-02 |
| 1144543687 | Robert P. Williamson Md, P.C. | Internal Medicine | 43 Forest St, Medford, MA 02155-3128 | 2010-03-11 |
| 1104013572 | Cooper Physician Offices | Internal Medicine | 13 Tomlinson Rd, Medford, NJ 08055 | 2007-10-01 |
| 1629196381 | Robin Miller | Internal Medicine | 760 Golf View Dr, Medford, OR 97504-9685 | 2007-03-27 |
| 1225153042 | Stacey Sperling | Internal Medicine | Tufts University Health Svcs, Medford, MA 02155 | 2007-03-20 |
| 1790841666 | James Glass | Internal Medicine | 103 Old Marlton Pike Ste 111, Medford, NJ 08055-8772 | 2006-12-28 |
| 1235225129 | George Schultz | Internal Medicine | 2900 Doctors Park Dr Ste 200, Medford, OR 97504-8198 | 2006-10-05 |
| Find all providers in MEDFORD | ||||
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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.