Basic Information
| Provider Information | |||||||||
| NPI: | 1760489181 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BIERAUGEL | ||||||||
| FirstName: | JEAN | ||||||||
| MiddleName: | T. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 555 BLACK OAK DR | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | MEDFORD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975048447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417343430 | ||||||||
| FaxNumber: | 5417343638 | ||||||||
| Practice Location | |||||||||
| Address1: | 555 BLACK OAK DR | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | MEDFORD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975048447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417343430 | ||||||||
| FaxNumber: | 5417323980 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2005 | ||||||||
| LastUpdateDate: | 12/30/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD19727 | OR | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.