Stafford, Ty William Denver
Stafford, Ty William Denver is an individual health care provider with primary practice located at 3407 Shamrock Ct , Gautier MS 39553. He recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as his primary health care specialty. Stafford, Ty William Denver can be contacted via phone (228) 497-0690.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X |
Profile Details
| NPI number | 1194852426 |
|---|---|
| LBN Legal business name | Stafford, Ty William Denver |
| Credentials | Bachelor of Arts (BA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 27th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194852426 | NPPES |
| Mississippi | MEDICAID | 00018214 |
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