Individual
DR. LISA LYNN STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2070 S STATE ROAD 39, FRANKFORT, IN 46041-7655
(765) 659-2020
(765) 654-4668
Mailing address
2070 S STATE ROAD 39, FRANKFORT, IN 46041-7655
(765) 659-2020
(765) 654-4668
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002840
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000230330
BLUE CROSS BLUE SHIELD
IN
05
—
200107990
—
IN
Enumeration date
08/31/2006
Last updated
11/24/2010
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