Stafford, Mark D

Stafford, Mark D is an individual health care provider with primary practice located at 6011 E Woodmen Rd Ste 360 , Colorado Springs CO 80923-2606. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Stafford, Mark D can be contacted via phone (719) 571-8550.

Contact Information

Primary practice address
6011 E Woodmen Rd Ste 360 Colorado Springs CO 80923-2606
Phone: (719) 571-8550
Fax: (719) 571-8555
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 1609 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-1609 Colorado

Profile Details

NPI number 1215901657
LBN Legal business name Stafford, Mark D
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2006
Last updated Mar 7th, 2018 - about 6 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 1215901657 NPPES
Colorado MEDICAID 06009271

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