Stafford, John Wiley

Stafford, John Wiley is an individual health care provider with primary practice located at 207 Westmark Blvd , Lafayette LA 70506-7365. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Stafford, John Wiley can be contacted via phone (337) 981-6811.

Contact Information

Primary practice address
207 Westmark Blvd Lafayette LA 70506-7365
Fax: (337) 981-2024
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 013845 Louisiana

Profile Details

NPI number 1831292358
LBN Legal business name Stafford, John Wiley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 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 1831292358 NPPES
Louisiana MEDICAID 1171000

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