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SISKIYOU VITAL MEDICINE LLC
NPI 1407442338
Clinic/Center - Primary Care in Medford, OR

Active since December 15, 2020
940 ELLENDALE DR # 102, MEDFORD, OR 97504(541) 210-5687(541) 392-4962 Get Directions Write a Review

NPPES record last updated: December 15, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Siskiyou Vital Medicine Llc NPPES

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

SISKIYOU VITAL MEDICINE LLC (NPI 1407442338) is a healthcare organization registered as a primary care in Medford, Oregon and active in the NPI registry since December 2020. The organization lists Gregory Mcclane Duncan, Owner/member, as its authorized official.

NPPES Registry Identity

NPI1407442338
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameSISKIYOU VITAL MEDICINE LLC
Location Address940 ELLENDALE DR # 102Medford, OR 97504-8216
Mailing Address940 Ellendale Dr # 102Medford, OR 97504-8216 · (541) 210-5687 · Fax (541) 392-4962
Phone(541) 210-5687
Fax(541) 392-4962
Organization SubpartNo
Authorized OfficialGregory Mcclane DuncanOwner/member · (541) 210-5687
Enumeration DateDecember 15, 2020
NPPES CertifiedDecember 15, 2020
✔ NPI 1407442338 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedClinic/Center · Community HealthTaxonomy 261QC1500X
Also ListedClinic/Center · Infusion TherapyTaxonomy 261QI0500X
Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X
940 ELLENDALE DR # 102, Medford, OR 97504
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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

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 Siskiyou Vital Medicine LLC's NPI number?

The NPI number for Siskiyou Vital Medicine LLC is 1407442338. It was assigned to this organization in the NPPES registry on December 15, 2020.

Where is Siskiyou Vital Medicine LLC located?

Siskiyou Vital Medicine LLC is located at 940 Ellendale Dr # 102, Medford, OR 97504. The listed phone number is (541) 210-5687.

What is Siskiyou Vital Medicine LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Siskiyou Vital Medicine LLC was last updated on December 15, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.