Individual
CLEO DENNIS STAFFORD II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3896 PRINCETON LAKES WAY, ATLANTA, GA 30331
(404) 489-4444
Mailing address
49 JESSE HILL JR DR SE, ATLANTA, GA 30303-3049
(404) 778-1550
(404) 778-1557
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
MD.35085
AL
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
77937
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/20/2012
Last updated
02/08/2019
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