Individual
JESSE A STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
346 N MAIN ST, DECATUR, AR 72722-9732
(479) 752-3233
(479) 752-3235
Mailing address
PO BOX 735, DECATUR, AR 72722-0735
(479) 752-3233
(479) 752-3235
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-598
AR
Other
Enumeration date
02/12/2015
Last updated
02/12/2015
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