Individual
MRS. ALICIA MARIE STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
01089757A
IN
2086S0129X
Vascular Surgery Physician
Primary
1025166
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01089757A
INDIANA STATE LICENSE
IN
01
—
01089757B
CSR
IN
05
—
300075440
—
IN
05
—
7100897790
—
KY
Enumeration date
06/20/2018
Last updated
07/24/2026
Update your record
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