Shirley A Malcolm (NPI# 1316951510, PAC ID# 2062542665) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OSTEOPATHIC MANIPULATIVE MEDICINE.
| Nation Provider ID (NPI) | 1316951510 |
| PAC ID by PECOS | 2062542665 |
| Professional Enrollment ID | I20100608000681 |
| Full Name | Shirley A Malcolm |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES OREGON |
| Address |
70 Bower Dr Medford OR 97504 |
| Phone Number | 5417323650 |
| Gender | F |
| Medical School | UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES |
| Graduation Year | 1990 |
| Primary Specialty | OSTEOPATHIC MANIPULATIVE MEDICINE |
| Secondary Specialties | FAMILY MEDICINE |
| Group Practice PAC ID | 5294623245 |
| Number of Group Practice Members | 189 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380075 | PROVIDENCE MEDFORD MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 70 Bower Dr, Medford, OR 97504 | 5417323650 | PROVIDENCE HEALTH AND SERVICES OREGON |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES OREGON |
| Physicians | 1491 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Yeong Paul Park | Physical Therapy | Providence Health and Services Oregon | 1627 Woods Ct, Prov Gorg Spi/spo M, Hood River, OR 97031-2915 |
| Traci Ackron | Family Medicine | Providence Health and Services Oregon | 909 Sw 18th Ave, Prov Med Gr Spor Car, Portland, OR 97205-1705 |
| Tierney Newman | Nurse Practitioner | Providence Health and Services Oregon | 4004 Kruse Way Pl, Suite 300, Lake Oswego, OR 97035-2479 |
| Angie R Cronin | Psychologist, Clinical | Providence Health and Services Oregon | 1332 S Shasta Ave, Suite A, Eagle Point, OR 97524-8623 |
| Jennifer N Herr | Nurse Practitioner | Providence Health and Services Oregon | 4805 Ne Glisan, Portland, OR 97213-2933 |
| Jaecelle Guadiz Galeniece | Family Medicine | Providence Health and Services Oregon | 1003 Providence Dr, Suite 325, Newberg, OR 97132-7521 |
| Amelia H Baker | Family Medicine | Providence Health and Services Oregon | 4920 N Interstate Ave, Portland, OR 97217-3653 |
| Sandra Iloka | Family Medicine | Providence Health and Services Oregon | 16770 Sw Edy Rd, 102 Pmg Sherwood Imed Cr, Sherwood, OR 97140-9679 |
| Duy Quang Tran | Family Medicine | Providence Health and Services Oregon | 839 Ne Holladay St, Portland, OR 97232-3521 |
| Steven Vorenkamp | Orthopedic Surgery | Providence Health and Services Oregon | 814 13th St, Hood River, OR 97031-1210 |
| Street Address |
70 BOWER DR |
| City | MEDFORD |
| State | OR |
| Zip | 97504 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kimberly Anne Zaslow | Family Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Benjamin Robert Oldson | Family Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Denise M Viss | Nurse Practitioner | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Carissa D Scalf | Psychologist, Clinical | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Wesley T Ramoso | Family Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Uzomechine Thabiso Chiedozi | Family Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Grant A Jolliffe | Nurse Practitioner | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Travis Adam Day | Nurse Practitioner | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jasmin Williams | Clinical Social Worker | Options for Southern Oregon | 1700 E Barnett Rd, Medford, OR 97504-0052 |
| Joann Lanae Reed | Nurse Practitioner | 2668 Montara Dr, Medford, OR 97504-2170 | |
| Scott P Byrd | Physical Therapy | Sporthopedics Physical Therapy, PC | 1060 Crater Lake Ave, Suite A, Medford, OR 97504-2203 |
| Becky J Gathercoal | Clinical Social Worker | 3550 National Dr, Medford, OR 97504-4003 | |
| Christine A Stanek | Nurse Practitioner | Rogue Valley Physicians | 3524 Heathrow Way, Medford, OR 97504-4004 |
| Karen A Kozleski | Nurse Practitioner | Rogue Valley Physicians | 3524 Heathrow Way, Medford, OR 97504-4004 |
| Scott E Wilson | Nurse Practitioner | Rogue Valley Physicians | 3524 Heathrow Way, Medford, OR 97504-4004 |
| Cindy A Konecne | Osteopathic Manipulative Medicine | Rogue Valley Physicians | 3524 Heathrow Way, Medford, OR 97504-4004 |
| Sita S Taibi | Physician Assistant | Rogue Valley Physicians | 3524 Heathrow Way, Medford, OR 97504-4004 |
| Michael Ray Miller | Clinical Social Worker | Rogue Valley Physicians | 3524 Heathrow Way, Medford, OR 97504-4004 |
| Find all physicians in zip 97504 | |||
| City | MEDFORD |
| Zip Code | 97504 |
| Specialty | OSTEOPATHIC MANIPULATIVE MEDICINE |
| City + Specialty | MEDFORD + OSTEOPATHIC MANIPULATIVE MEDICINE |
Please comment or provide details below to improve the information on Shirley A Malcolm.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.