Individual
SUSAN VANDERZYL STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
950 N 19TH ST STE 100, ABILENE, TX 79601-2420
(325) 670-6370
Mailing address
950 N 19TH ST STE 100, ABILENE, TX 79601-2420
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
BP10054444
TX
208C00000X
Colon & Rectal Surgery Physician
Primary
S5080
TX
Other
Enumeration date
05/19/2015
Last updated
01/11/2022
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