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General NPI Number Information
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NPI Number | 1083252472
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Entity Type | Organization
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Legal Business Name | DRIVEN ENTERPRISES PC
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Dates
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Enumeration Date | 12/16/2019
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Last Update Date | 01/30/2020
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Provider Practice Location Address
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Address Line | 20700 WANDALEA DR
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City | BEND
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State | OR
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Zip | 97701-1594
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Country | US
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Telephone | 435-669-2930
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Fax |
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Provider Business Mailing Address
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Address Line | 20700 WANDALEA DR
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City | BEND
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State | OR
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Zip | 97701-1594
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Country | US
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Telephone | 435-669-2930
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. LANCE SPENCER ADAMS
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Credential | MD
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Telephone | 435-669-2930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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