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Organization

STAYTON FAMILY PRACTICE INC

Active
Other names
Jefferson Medical Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LANCE B LARGE MD (OWNER)
(503) 400-6140
Entity
Organization

Contact information

Practice address
294 2ND ST N, JEFFERSON, OR 97352
(541) 327-2380
(541) 327-2382
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

Other

Enumeration date
09/10/2009
Last updated
06/15/2022
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