Individual
SAMUEL JOSEPH DRIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1307 W MAIN ST, MEDFORD, OR 97501-2936
(541) 535-6239
Mailing address
931 CHEVY WAY, MEDFORD, OR 97504-4127
(541) 512-3182
(541) 512-1026
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA207720
OR
Other
Enumeration date
01/20/2021
Last updated
11/04/2021
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