Basic Information
| Provider Information | |||||||||
| NPI: | 1528359577 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FURNISS | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | WRAY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1096 HELEN AVE | ||||||||
| Address2: | |||||||||
| City: | UKIAH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 954825627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5107172552 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5144 HILL RD E | ||||||||
| Address2: | |||||||||
| City: | LAKEPORT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 954536300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7072638955 | ||||||||
| FaxNumber: | 7072638340 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2011 | ||||||||
| LastUpdateDate: | 12/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 20A15566 | CA | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.