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Organization
STAYTON FAMILY PRACTICE INC
Active
Organization
STAYTON FAMILY PRACTICE INC
Active
Other names
Lebanon Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE BRANDON LARGE MD (MEDICAL DIRECTOR)
(503) 400-6140
Entity
Organization
Contact information
Practice address
41 E ASH ST, LEBANON, OR 97355-3317
(503) 769-2641
(503) 769-3797
Mailing address
1881 W WASHINGTON ST, STAYTON, OR 97383-9511
(503) 400-6140
(503) 769-3797
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/01/2018
Last updated
06/15/2022
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