OrganizationActive
Rogue Medical LLC
NPI 1265298400 · Medical Physician Assistant · Phoenix, OR
Provider details
- NPI number
- 1265298400
- Entity type
- Organization
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Ben Johnson, Owner(541) 778-4517
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Surgical Physician Assistant363AS0400X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
205 N Phoenix Rd Ste 430
Phoenix, OR 97535-9108
Phone: (541) 778-4517
Fax: (541) 833-0995
Approximate (ZIP-level) locationGet directions
Mailing address
205 N Phoenix Rd
Phoenix, OR 97535-9101
Registry dates
- Enumerated
- 2024-02-26
- Last updated
- 2024-02-26
- Certified
- 2024-02-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.