# MRS. ALICIA MARIE STAFFORD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1609360890
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 01089757A | IN | — |
| 2086S0129X | Vascular Surgery Physician | 1025166 | MA | Yes |

## Other

- **Enumeration date:** 06/20/2018
- **Last updated:** 09/29/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01089757A | INDIANA STATE LICENSE | IN |
| 01 | — | 01089757B | CSR | IN |
| 05 | — | 300075440 | — | IN |
| 05 | — | 7100897790 | — | KY |