| Stayton Family Practice Inc | |
|
294 2nd St N Jefferson OR 97352 | |
| (541) 327-2380 | |
| (541) 327-2382 |
| Full Name | Stayton Family Practice Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 294 2nd St N, Jefferson, Oregon |
| Authorized Official Name and Position | Lance B Large (OWNER) |
| Authorized Official Contact | 5034006140 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stayton Family Practice Inc 1881 W Washington St Stayton OR 97383-9511 Ph: (503) 400-6140 | Stayton Family Practice Inc 294 2nd St N Jefferson OR 97352 Ph: (541) 327-2380 |
| NPI Number | 1285967133 |
|---|---|
| Provider Enumeration Date | 09/10/2009 |
| Last Update Date | 06/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285967133 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |