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Centennial Medical Group Inc fax number

(541) 229-0213

Orthopedics

Used for: New patient registration and intake submission

Fax destination details

Department
Orthopedics
Purpose
New patient registration and intake submission
Form
New patient registration form — Centennial Medical Group Orthopedics New Patient Registration/Consent Form
Address
2460 NW Stewart Parkway, Suite 100, Roseburg, OR 97471
Voice phone
541-229-2663

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  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Complete the patient information and consent sections in the form and submit to Centennial Medical Group. For submission by fax, send to 541-229-0213; include patient name and DOB.

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