Individual
MR. DARRON S STANDIFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5354 REYNOLDS ST STE 102, SAVANNAH, GA 31405-6008
(912) 819-0500
(912) 819-0501
Mailing address
602 E 72ND ST, SAVANNAH, GA 31405-4913
(912) 819-7878
(912) 819-7850
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006105
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6105
GEORGIA MEDICAL LICENSE
GA
Enumeration date
05/10/2011
Last updated
02/15/2018
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