1316975543 NPI number — DR. FRANK CLAYTON STAFFORD JR. DO, DC

Table of content: ALLISON CADDEN (NPI 1871281782)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316975543 NPI number — DR. FRANK CLAYTON STAFFORD JR. DO, DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STAFFORD
Provider First Name:
FRANK
Provider Middle Name:
CLAYTON
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
DO, DC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316975543
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/30/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 ANDREWS AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT RUCKER
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36362-5333
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-261-7193
Provider Business Mailing Address Fax Number:
334-255-7710

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
814 MARSHALL ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT RILEY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66442-4458
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-652-6066
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/28/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2083X0100X , with the licence number:  DO.1749 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2083A0100X , with the licence number: DO.1749 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 60554711200001 . This is a "BCBS" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 5684445 . This is a "MAILHANDLERS PROVIDER ID" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".