Stafford, Jesse Ray

Stafford, Jesse Ray is an individual health care provider with primary practice located at 8 Memorial Medical Ct Suite 1, Greenville SC 29605-4455. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cytopathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Stafford, Jesse Ray can be contacted via phone (864) 295-3492.

Contact Information

Primary practice address
8 Memorial Medical Ct Suite 1 Greenville SC 29605-4455
Phone: (864) 295-3492
Fax: (864) 295-4817
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cytopathology 207ZC0500X 12067 South Carolina
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 12067 South Carolina

Profile Details

NPI number 1306896543
LBN Legal business name Stafford, Jesse Ray
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Nov 11th, 2010 - about 14 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 1306896543 NPPES
South Carolina MEDICAID 120672

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