Individual
CHARLES TANNER STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
119 N. DONALSON ST., SUITE B, BAINBRIDGE, GA 39817
(229) 220-0780
Mailing address
119 N. DONALSON ST., SUITE B, BAINBRIDGE, GA 39817
(229) 220-0780
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
017767
GA
Other
Enumeration date
09/09/2008
Last updated
02/21/2013
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