Individual
ANDY J. STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2920 MCINTYRE DR, SUITE 250, BLOOMINGTON, IN 47403-4221
(812) 332-9217
(812) 330-4474
Mailing address
PO BOX 1329, BLOOMINGTON, IN 47402-1329
(812) 353-2154
(812) 353-5228
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01031189
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100207000A
—
IN
Enumeration date
10/27/2006
Last updated
12/23/2020
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