Individual
LARRY K STAUFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1432 SOUTHWEST BLVD, JEFFERSON CITY, MO 65109
(573) 632-5576
(573) 632-5860
Mailing address
PO BOX 1128, CAPITAL REGION FAMILY EYE CARE, JEFFERSON CITY, MO 65102-1128
(573) 632-5576
(573) 632-5860
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
32512
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109982
HEALTHLINK
—
01
—
180038736
RR MEDICARE
—
05
—
200790814
—
MO
01
—
21857
BLUE CROSS BLUE SHIELD
—
01
—
815387
FIRST HEALTH
—
01
—
A12009
MERCY
—
Enumeration date
02/15/2006
Last updated
06/17/2009
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