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Individual
GREGORY LEE STAFFORD
Active
Individual
GREGORY LEE STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2002012315
MO
363A00000X
Physician Assistant
4960
OK
363A00000X
Physician Assistant
Primary
MED-PAC-LIC-175253
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201146590A
—
OK
Enumeration date
05/24/2006
Last updated
09/18/2026
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