# JOHN L STAFFORD MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316591639
- **Authorized official:** JOHN STAFFORD MD (OWNER)
- **Authorized official phone:** (812) 254-2400

## Contact information

- **Practice address:** 1401 MEMORIAL AVE STE B, WASHINGTON, IN 47501-3154
- **Practice address phone:** (812) 254-2400
- **Practice address fax:** (812) 254-3191
- **Mailing address:** 1401 MEMORIAL AVE STE B, WASHINGTON, IN 47501-3154
- **Mailing address phone:** (812) 254-2400
- **Mailing address fax:** (812) 254-3191

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/25/2019
- **Last updated:** 09/10/2019