Healthcare Provider Details

I. General information

NPI: 1639073422
Provider Name (Legal Business Name): LITTLE MEDICINE RANCH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 NW ARIZONA AVE STE 200
BEND OR
97703-3298
US

IV. Provider business mailing address

701 NW ARIZONA AVE STE 200
BEND OR
97703-3298
US

V. Phone/Fax

Practice location:
  • Phone: 458-281-5241
  • Fax: 541-559-3860
Mailing address:
  • Phone: 458-281-5241
  • Fax: 541-559-3860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ALEKSANDER ROBLES
Title or Position: OWNER
Credential: MD
Phone: 406-334-4091