Provider Demographics
NPI:1871758003
Name:GARTH MELDRUM MD LLC
Entity type:Organization
Organization Name:GARTH MELDRUM MD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GARTH
Authorized Official - Last Name:MELDRUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-285-6440
Mailing Address - Street 1:244 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2200
Mailing Address - Country:US
Mailing Address - Phone:541-285-6440
Mailing Address - Fax:541-683-5389
Practice Address - Street 1:244 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2200
Practice Address - Country:US
Practice Address - Phone:541-285-6440
Practice Address - Fax:541-683-5389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD25711208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty