LIFESTYLE MEDICINE OF CENTRAL OREGON, PC - NPI 1013264456

Q: What is the provider's specialty?

The provider's specialty is Obstetrics & Gynecology with taxonomy code 207VG0400X and a focus in Gynecology.

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About Lifestyle Medicine Of Central Oregon, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFESTYLE MEDICINE OF CENTRAL OREGON, PC (NPI 1013264456) is a healthcare organization registered as a gynecology in Bend, Oregon and active in the NPI registry since August 2012. The organization lists Mary Huntsman, Owner, as its authorized official.

NPPES Registry Identity

NPI1013264456

Entity TypeOrganization

Primary Taxonomy207VG0400X

Legal Business NameLIFESTYLE MEDICINE OF CENTRAL OREGON, PC

Location Address497 SW CENTURY DR, SUITE 120Bend, OR 97702-1167

Mailing Address497 Sw Century Dr, Suite 120Bend, OR 97702-1167 · (541) 291-9960 · Fax (541) 291-9961

Phone(541) 291-9960

Fax(541) 291-9961

Organization SubpartNo

Authorized OfficialMary HuntsmanOwner · (541) 291-9960

Enumeration DateAugust 3, 2012

Last NPPES UpdateApril 16, 2013

✔ NPI 1013264456 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207VG0400X

License✔ Licensed in OR · MD17360

Definition

A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee

497 SW CENTURY DR, Bend, OR 97702

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP