Organization
LARRY WAMPLER DO PC
Active
Organization
LARRY WAMPLER DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY R WAMPLER DO (PRESIDENT)
(541) 758-5047
Entity
Organization
Contact information
Practice address
930 SW ABBEY ST, NEWPORT, OR 97365-4820
(541) 265-2244
(541) 574-2858
Mailing address
PO BOX 932, CORVALLIS, OR 97339-0932
(541) 758-5047
(541) 758-3713
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
11879
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
230987
—
OR
Enumeration date
05/11/2006
Last updated
05/07/2008
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