Stafford, Gary Lee

Stafford, Gary Lee is an individual health care provider with primary practice located at 550 Fort Loudoun Medical Center Dr , Lenoir City TN 37772-5673. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Stafford, Gary Lee can be contacted via phone (865) 271-6035.

Contact Information

Primary practice address
550 Fort Loudoun Medical Center Dr Lenoir City TN 37772-5673
Phone: (865) 271-6035
Fax: (865) 271-6262
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 27430 Tennessee
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X BS4671966 Tennessee

Profile Details

NPI number 1245272400
LBN Legal business name Stafford, Gary Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245272400 NPPES
Tennessee MEDICAID 3098382
Tennessee Other 3079249

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