Mark Frederick Deatherage (NPI# 1841293156, PAC ID# 8123041324) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is VASCULAR SURGERY.
| Nation Provider ID (NPI) | 1841293156 |
| PAC ID by PECOS | 8123041324 |
| Professional Enrollment ID | I20101119000489 |
| Full Name | Mark Frederick Deatherage |
| Organization Legal Name | GRANTS PASS SURGICAL ASSOCIATES, P.C. |
| Address |
1600 Nw 6th St Suite N Grants Pass OR 97526-1094 |
| Phone Number | 5414745533 |
| Gender | M |
| Medical School | OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE |
| Primary Specialty | VASCULAR SURGERY |
| Group Practice PAC ID | 0143217315 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380002 | ASANTE THREE RIVERS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1600 Nw 6th St, Suite N, Grants Pass, OR 97526-1094 | 5414745533 | GRANTS PASS SURGICAL ASSOCIATES, P.C. |
| Organization Legal Name | GRANTS PASS SURGICAL ASSOCIATES, P.C. |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melissa M Greive | General Surgery | Grants Pass Surgical Associates, P.C. | 1600 Nw 6th St, Suite N, Grants Pass, OR 97526-1094 |
| David C Oehling | General Surgery | Grants Pass Surgical Associates, P.C. | 1600 Nw 6th St N, Grants Pass, OR 97526-1094 |
| Mark A Jones | Vascular Surgery | Grants Pass Surgical Associates, P.C. | 1600 Nw 6th St, Suite N, Grants Pass, OR 97526-1094 |
| Street Address |
1600 NW 6TH ST SUITE N |
| City | GRANTS PASS |
| State | OR |
| Zip | 97526-1094 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melissa M Greive | General Surgery | Grants Pass Surgical Associates, P.C. | 1600 Nw 6th St, Suite N, Grants Pass, OR 97526-1094 |
| Darlena Pike | Nurse Practitioner | Optimal Health of Southern Oregon, LLC | 1600 Nw 6th St, South Suite, Grants Pass, OR 97526-1094 |
| Wendell C Heidinger | Family Medicine | Optimal Health of Southern Oregon, LLC | 1600 Nw 6th St, South Suite, Grants Pass, OR 97526-1094 |
| Mark A Jones | Vascular Surgery | Grants Pass Surgical Associates, P.C. | 1600 Nw 6th St, Suite N, Grants Pass, OR 97526-1094 |
| Jeremy Scott Cathey | Nurse Practitioner | Optimal Health of Southern Oregon, LLC | 1600 Nw 6th St, South Suite, Grants Pass, OR 97526-1094 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Keith R Anderson | Certified Registered Nurse Anesthetist (crna) | Rogue Anesthesia LLC | 1601 Nw Hawthorne Ave, Grants Pass, OR 97526-1041 |
| Matthew A Fagert | Certified Registered Nurse Anesthetist (crna) | Rogue Anesthesia LLC | 1601 Nw Hawthorne Ave, Grants Pass, OR 97526-1041 |
| Keith A Jensen | Certified Registered Nurse Anesthetist (crna) | Rogue Anesthesia LLC | 1601 Nw Hawthorne Ave, Grants Pass, OR 97526-1041 |
| Joseph Fowler | Certified Registered Nurse Anesthetist (crna) | Rogue Anesthesia LLC | 1601 Nw Hawthorne Ave, Grants Pass, OR 97526-1041 |
| Tori Lynn Rumrey | Nurse Practitioner | 1585 Nw Washington Blvd, Grants Pass, OR 97526-1049 | |
| Robert M Gentry | Family Practice | Rumrey Family Practice, LLC | 1585 Nw Washington Blvd, Grants Pass, OR 97526-1049 |
| Dan Phillip Gleffe | Family Medicine | 1587 Nw Washington Blvd, Grants Pass, OR 97526-1085 | |
| David C Oehling | General Surgery | Grants Pass Surgical Associates, P.C. | 1600 Nw 6th St N, Grants Pass, OR 97526-1094 |
| Angela M Dedionisio | Optometry | Eye Care Group of Southern Oregon PC | 1022 Nw 6th St, Grants Pass, OR 97526-1114 |
| Scott M Walters | Optometry | Eye Care Group of Southern Oregon PC | 1022 Nw 6th St, Grants Pass, OR 97526-1114 |
| Find all physicians in zip 97526 | |||
| City | GRANTS PASS |
| Zip Code | 97526 |
| Specialty | VASCULAR SURGERY |
| City + Specialty | GRANTS PASS + VASCULAR SURGERY |
Please comment or provide details below to improve the information on Mark Frederick Deatherage.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.