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Organization
SMALL TOWN PEDIATRICS LLC
Active
Organization
SMALL TOWN PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS SCOTT HAMBLIN MD (OWNER/PEDIATRICIAN)
(971) 304-9855
Entity
Organization
Contact information
Practice address
607 WELCH ST, SILVERTON, OR 97381-1946
(503) 400-3852
(503) 334-2268
Mailing address
PO BOX 1430, SILVERTON, OR 97381-0106
(503) 400-3852
(503) 334-2268
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500675213
—
OR
Enumeration date
06/29/2021
Last updated
06/29/2021
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