Individual
DR. GARY LEE STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 FORT LOUDOUN MEDICAL CENTER DR, LENOIR CITY, TN 37772-5673
(865) 271-6035
(865) 271-6262
Mailing address
1400 ANTIOCH CHURCH RD W, LENOIR CITY, TN 37772-5009
(865) 986-4120
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
27430
TN
207P00000X
Emergency Medicine Physician
Primary
BS4671966
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3079249
BLUE CROSS
TN
05
—
3098382
—
TN
Enumeration date
06/12/2006
Last updated
07/08/2007
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