Individual
MR. TODD E STANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
281 N. LYERLY ST., SUITE 200, CHATTANOOGA, TN 37404
(423) 698-0850
(423) 698-0511
Mailing address
281 N. LYERLY ST., SUITE 200, CHATTANOOGA, TN 37404
(423) 698-0850
(423) 698-0511
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1448
TN
363A00000X
Physician Assistant
4958
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4223195
BCBS OF TN
TN
Enumeration date
01/21/2007
Last updated
03/28/2017
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