Basic Information
| Provider Information | |||||||||
| NPI: | 1376535302 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAVINO | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | MARK | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 825 BENNETT AVE | ||||||||
| Address2: | |||||||||
| City: | MEDFORD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975046715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417795228 | ||||||||
| FaxNumber: | 5417721533 | ||||||||
| Practice Location | |||||||||
| Address1: | 825 BENNETT AVE | ||||||||
| Address2: | |||||||||
| City: | MEDFORD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975046715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417795228 | ||||||||
| FaxNumber: | 5417721533 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2005 | ||||||||
| LastUpdateDate: | 10/19/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MD26023 | OR | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | MD26023 | OR | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 269939 | 05 | OR | MEDICAID |