Individual
MICHAEL TRACE STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1123 BELLEVILLE AVE, BREWTON, AL 36426-1505
(251) 867-8001
(251) 867-9643
Mailing address
1123 BELLEVILLE AVE, BREWTON, AL 36426-1505
(251) 867-8001
(251) 867-9643
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
DO.2013
AL
Other
Enumeration date
07/03/2014
Last updated
08/05/2020
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