PARK AVENUE DERMATOLOGY CLINIC
NPI 1043398159
Specialist in Coos Bay, OR

Q: What is Edgar Maeyens Jr MD PC's NPI number?

The NPI number for Edgar Maeyens Jr MD PC is 1043398159. It was assigned to this organization in the NPPES registry on November 2, 2006. The provider is doing business as Park Avenue Dermatology Clinic.

Q: What is Edgar Maeyens Jr MD PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since November 02, 2006

375 PARK AVE, SUITE 5, COOS BAY, OR 97420(541) 267-7543(541) 267-2076 Get Directions Write a Review

NPPES record last updated: June 17, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Park Avenue Dermatology Clinic NPPES

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

PARK AVENUE DERMATOLOGY CLINIC (NPI 1043398159) is a healthcare organization registered as a specialist in Coos Bay, Oregon and active in the NPI registry since November 2006. The organization lists Edgar Maeyens, Doctor, as its authorized official.

NPPES Registry Identity

NPI1043398159

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameEDGAR MAEYENS JR MD PC

Location Address375 PARK AVE, SUITE 5Coos Bay, OR 97420-2244

Mailing Address375 Park Ave, Suite 5Coos Bay, OR 97420-2244 · (541) 267-7543 · Fax (541) 267-2076

Phone(541) 267-7543

Fax(541) 267-2076

Organization SubpartNo

Authorized OfficialEdgar MaeyensDoctor · (541) 267-7543

Enumeration DateNovember 2, 2006

Last NPPES UpdateJune 17, 2008

✔ NPI 1043398159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in OR · MD08528

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

375 PARK AVE, Coos Bay, OR 97420

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Other Names 1

Doing Business AsPark Avenue Dermatology Clinic

Other Identifiers 3

Medicare UPINC93204OR

Other009894000OR · Blue Cross Id #

Medicare PINR112711OR

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. SARAH BETH CAMPBELL LCSW

Counselor (Mental Health)

375 PARK AVE, STE 2
COOS BAY, OR 97420

Coos County (559) 374-2240

MS. ERIN ELIZABETH SPIER LPC

Case Manager/Care Coordinator

375 PARK AVE, SUITE 2
COOS BAY, OR 97420

Coos County (541) 808-4719

CREATIVE ROOTS THERAPY LLC

Counselor (Professional)

375 PARK AVE, SUITE B
COOS BAY, OR 97420

Coos County (541) 808-4719

CONNIE BURNETT LPC

Counselor (Professional)

375 PARK AVE
COOS BAY, OR 97420

Coos County (406) 925-1313

ACESO MEDICAL CLINIC LLC

Nurse Practitioner (Family)

375 PARK AVE
COOS BAY, OR 97420

Coos County (773) 996-0242

EDGAR MAEYENS MD

Dermatology (MOHS-Micrographic Surgery)

375 PARK AVE, SUITE 5
COOS BAY, OR 97420

Coos County (541) 267-7543

MS. CARRIE LEE SOCHA BAIRD MASTERS DEGREE MARRI

Marriage & Family Therapist

375 PARK AVE
COOS BAY, OR 97420

Coos County (541) 995-7220

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edgar Maeyens Jr MD PC's NPI number?

The NPI number for Edgar Maeyens Jr MD PC is 1043398159. It was assigned to this organization in the NPPES registry on November 2, 2006. The provider is doing business as Park Avenue Dermatology Clinic.

Where is Edgar Maeyens Jr MD PC located?

Edgar Maeyens Jr MD PC is located at 375 Park Ave Suite 5, Coos Bay, OR 97420. The listed phone number is (541) 267-7543.

What is Edgar Maeyens Jr MD PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Edgar Maeyens Jr MD PC was last updated on June 17, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.