Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD181473 | OR |
NPI | 1215227756 |
---|---|
Provider Name | Mark Eugene Mildren |
First Address | Eugene, OR 97401-2433 |
Second Address | Eugene, OR 97401-2433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2011 |
Last Update Date | 07/08/2020 |