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Matthew T Stark, PA-C
Medical Physician Assistant in Roseburg, Oregon
NPI 1174700934

Matthew T Stark is a Medical Physician Assistant based in Roseburg, OR and is specialized in Medical. Matthew T Stark practices in Roseburg, OR and has the professional credentials of PA-C. The NPI Number for Matthew T Stark is 1174700934 and holds a License No. (Oregon).

The current practice location address for Matthew T Stark is 1937 W Harvard Ave, Roseburg, OR and can be reached out via phone at 541-677-7200 and via fax at 541-229-3309. You can also correspond with Matthew T Stark through the mailing address at 2570 NW EDENBOWER BLVD STE 100, ROSEBURG, OR - 97471-6214 (mailing address contact number: 541-677-7200).

Location: 1937 W Harvard Ave, Roseburg, OR, 97471-6214
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1174700934
Provider Name
Matthew T Stark
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
1937 W Harvard Ave, Roseburg, OR, 97471-6214
Phone Number
541-677-7200
Fax Number
541-229-3309
Provider Enumeration Date
01/23/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500652217 05 OR
institution
Provider Business Practice Location Address Details
Address
1937 W Harvard Ave
City
Roseburg
State
Oregon
Zip
97471-2720
Phone Number
541-677-7200
Fax Number
541-229-3309
person
Provider Business Mailing Address Details
Address
1937 W Harvard Ave
City
Roseburg
State
Oregon
Zip
97471-2720
Phone Number
541-677-7200
Fax Number
541-229-3309
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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