Provider Demographics
NPI:1245482967
Name:DOUGLAS A. BITTER M.D., P.C.
Entity type:Organization
Organization Name:DOUGLAS A. BITTER M.D., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:BITTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-673-1016
Mailing Address - Street 1:171 MEDICAL LOOP
Mailing Address - Street 2:SUITE 160
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-8822
Mailing Address - Country:US
Mailing Address - Phone:541-673-1016
Mailing Address - Fax:541-673-0472
Practice Address - Street 1:171 MEDICAL LOOP
Practice Address - Street 2:SUITE 160
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-8822
Practice Address - Country:US
Practice Address - Phone:541-673-1016
Practice Address - Fax:541-673-0472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-13
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16080208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty