Organization
C. CRAIG STAFFORD, MD PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES CRAIG STAFFORD MD (OWNER/MD)
(859) 373-0215
Entity
Organization
Contact information
Practice address
1401 HARRODSBURG ROAD, A-450, LEXINGTON, KY 40504-3794
(859) 373-0215
(859) 373-0235
Mailing address
1401 HARRODSBURG RD, BLDG A STE 450, LEXINGTON, KY 40504-3751
(859) 373-0215
(859) 373-0235
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
24728
KY
363L00000X
Nurse Practitioner
3004939
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100143740
—
KY
05
—
7100144720
—
KY
Enumeration date
10/05/2010
Last updated
02/22/2011
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