| Bruce A. Stafford, Do, Pc | |
|
15809 Ne 23rd St Choctaw OK 73020-8428 | |
| (405) 390-4280 | |
| (405) 390-4282 |
| Full Name | Bruce A. Stafford, Do, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 15809 Ne 23rd St, Choctaw, Oklahoma |
| Authorized Official Name and Position | Bruce A. Stafford (PHYSICIAN) |
| Authorized Official Contact | 4053904280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bruce A. Stafford, Do, Pc 15809 Ne 23rd St Choctaw OK 73020-8428 Ph: (405) 390-4280 | Bruce A. Stafford, Do, Pc 15809 Ne 23rd St Choctaw OK 73020-8428 Ph: (405) 390-4280 |
| NPI Number | 1639267362 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 09/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639267362 | NPI | - | NPPES |
| 200019750A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 3919 (Oklahoma) | Primary |
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