Jacob Stuart Grange (NPI# 1508200833, PAC ID# 3375770217) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PATHOLOGY.
| Nation Provider ID (NPI) | 1508200833 |
| PAC ID by PECOS | 3375770217 |
| Professional Enrollment ID | I20180521001427 |
| Full Name | Jacob Stuart Grange |
| Organization Legal Name | VISTA PATHOLOGY LABORATORY LLC |
| Address |
1032 E Jackson St Medford OR 97504-7027 |
| Phone Number | 5417704559 |
| Gender | M |
| Medical School | UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS |
| Graduation Year | 2013 |
| Primary Specialty | PATHOLOGY |
| Group Practice PAC ID | 4587827985 |
| Number of Group Practice Members | 13 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380018 | ASANTE ROGUE REGIONAL MEDICAL CENTER |
| 380002 | ASANTE THREE RIVERS MEDICAL CENTER |
| 380075 | PROVIDENCE MEDFORD MEDICAL CENTER |
| 381322 | CURRY GENERAL HOSPITAL |
| 380005 | ASANTE ASHLAND COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1032 E Jackson St, Medford, OR 97504-7027 | 5417704559 | VISTA PATHOLOGY LABORATORY LLC |
| Organization Legal Name | VISTA PATHOLOGY LABORATORY LLC |
| Physicians | 16 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bryan P Wu | Pathology | Vista Pathology Laboratory LLC | 1032 E Jackson St, Medford, OR 97504-7027 |
| Melissa E Kahn | Pathology | Vista Pathology Laboratory LLC | 1032 E Jackson St, Medford, OR 97504-7027 |
| Gabriella Cardoza-favarato | Pathology | Vista Pathology Laboratory LLC | 1032 E Jackson St, Medford, OR 97504-7027 |
| Randal R Nixon | Pathology | Vista Pathology Laboratory LLC | 1032 E Jackson St, Medford, OR 97504-7027 |
| Robin C Pike | Pathology | Vista Pathology Laboratory LLC | 94220 4th St, Gold Beach, OR 97444-7756 |
| Michael D Kyle | Pathology | Vista Pathology Laboratory LLC | 94220 4th St, Gold Beach, OR 97444-7756 |
| Thu Phuong Tran | Pathology | Vista Pathology Laboratory LLC | 1032 E Jackson St, Medford, OR 97504-7027 |
| Allison Loudermilk | Pathology | Vista Pathology Laboratory LLC | 94220 4th St, Gold Beach, OR 97444-7756 |
| Colin P Newbill | Pathology | Vista Pathology Laboratory LLC | 1032 E Jackson St, Medford, OR 97504-7027 |
| Anne Yee Huang | Pathology | Vista Pathology Laboratory LLC | 1032 E Jackson St, Medford, OR 97504-7027 |
| Street Address |
1032 E JACKSON ST |
| City | MEDFORD |
| State | OR |
| Zip | 97504-7027 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bryan P Wu | Pathology | Vista Pathology Laboratory LLC | 1032 E Jackson St, Medford, OR 97504-7027 |
| Melissa E Kahn | Pathology | Vista Pathology Laboratory LLC | 1032 E Jackson St, Medford, OR 97504-7027 |
| Gabriella Cardoza-favarato | Pathology | Vista Pathology Laboratory LLC | 1032 E Jackson St, Medford, OR 97504-7027 |
| Randal R Nixon | Pathology | Vista Pathology Laboratory LLC | 1032 E Jackson St, Medford, OR 97504-7027 |
| Thu Phuong Tran | Pathology | Vista Pathology Laboratory LLC | 1032 E Jackson St, Medford, OR 97504-7027 |
| Colin P Newbill | Pathology | Vista Pathology Laboratory LLC | 1032 E Jackson St, Medford, OR 97504-7027 |
| Anne Yee Huang | Pathology | Vista Pathology Laboratory LLC | 1032 E Jackson St, Medford, OR 97504-7027 |
| Michael T Reedy | Pathology | Vista Pathology Laboratory LLC | 1032 E Jackson St, Medford, OR 97504-7027 |
| Todd Skipper Barry | Pathology | Vista Pathology Laboratory LLC | 1032 E Jackson St, Medford, OR 97504-7027 |
| Thomas R Treger | Pathology | Vista Pathology Laboratory LLC | 1032 E Jackson St, Medford, OR 97504-7027 |
| Find all physicians in the same address | |||
| 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 |
| Shirley A Malcolm | Osteopathic Manipulative 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 |
| Jasmin Williams | Clinical Social Worker | Options for Southern Oregon | 1700 E Barnett Rd, Medford, OR 97504-0052 |
| Find all physicians in zip 97504 | |||
| City | MEDFORD |
| Zip Code | 97504 |
| Specialty | PATHOLOGY |
| City + Specialty | MEDFORD + PATHOLOGY |
Please comment or provide details below to improve the information on Jacob Stuart Grange.
| 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.