Individual
DR. EDWARD CLARKE STANDIFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4071 TATES CREEK CENTRE DR, SUITE 100, LEXINGTON, KY 40517-3062
(859) 273-3888
(859) 272-3256
Mailing address
PO BOX 910670, LEXINGTON, KY 40591-0670
(859) 971-4685
(859) 971-4602
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20895
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64208952
—
KY
Enumeration date
07/11/2005
Last updated
12/03/2020
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