Organization
DAVID G. SANFORD, M.D., P.S.C.
Active
Parent organization
DAVID G SANFORD, M.D., P.S.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAVID G SANFORD, M.D., P.S.C.
Authorized official
DAVID SANFORD MD (OWNER)
(606) 248-0932
Entity
Organization
Contact information
Practice address
409 N BROAD ST, NEW TAZEWELL, TN 37825-6607
(423) 615-4372
Mailing address
1502 CUMBERLAND AVE, MIDDLESBORO, KY 40965-1223
(606) 248-0932
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000284679
ANTHEM GROUP NUMBER
KY
Enumeration date
10/01/2021
Last updated
10/01/2021
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