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Individual

JOSEPH WILLIAM STAFFORD JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
312 N KENTUCKY AVE, WEST PLAINS, MO 65775-2073
(417) 257-7076
(417) 257-1417
Mailing address
312 N KENTUCKY AVE, WEST PLAINS, MO 65775-2073
(417) 257-7076
(417) 257-1417

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
R3F13
MO
261QR1300X
Rural Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
202169405
MO
Enumeration date
06/28/2005
Last updated
09/06/2012
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