Individual
GREGORY LEE STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6161 S YALE AVE, TULSA, OK 74136-1902
(918) 502-1900
(918) 494-6303
Mailing address
6600 S YALE AVE STE 1400, TULSA, OK 74136-3331
(888) 247-0125
(918) 502-8210
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2002012315
MO
363A00000X
Physician Assistant
Primary
4960
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201146590A
—
OK
Enumeration date
05/24/2006
Last updated
05/19/2023
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