Charles Tanner Stafford
Gynecologist
119 N. Donalson St. Suite B
Bainbridge
, Georgia 39817
Charles Tanner Stafford
Gynecologist
119 N. Donalson St. Suite B
Bainbridge
, Georgia 39817
(229) 220-0780
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About
Features
Specialties
- Gynecologist
Languages spoken
- English
Location
First Address
- Charles Tanner Stafford
- 119 N. Donalson St. Suite B
- Bainbridge, GA
- Zip : 39817
- Phone : (229) 220-0780
Second Address
- Charles Tanner Stafford
- 119 N. Donalson St. Suite B
- Bainbridge, GA
- Zip : 39817
- Phone : (229) 220-0780
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207VG0400X | Gynecologist | 017767 | GA |
National Provider Identifier
| NPI | 1104074699 |
|---|---|
| Provider Name | Charles Tanner Stafford |
| First Address | Bainbridge, GA 39817 |
| Second Address | Bainbridge, GA 39817 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/09/2008 |
| Last Update Date | 21/02/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| D42298 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.