Individual
CLYDE MCCLELLAN STAUFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7001 ROGERS AVE STE 600, FORT SMITH, AR 72903-4073
(479) 573-3101
(479) 573-3102
Mailing address
7001 ROGERS AVE STE 600, FORT SMITH, AR 72903-4073
(479) 573-3101
(479) 573-3102
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
E-15156
AR
390200000X
Student in an Organized Health Care Education/Training Program
5101022979
MI
Other
Enumeration date
05/15/2017
Last updated
08/04/2022
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