Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | ME038640 | FL |
NPI | 1790713139 |
---|---|
Provider Name | Dr. Arlen Stauffer |
First Address | Parker, CO 80134-5603 |
Second Address | Parker, CO 80134-5603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 23/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
067499100 | (05) | FL |
1790713139 | TRICARE (01) | FL |
64470 | BLUE CROSS BLUE SHIELD OF FLORIDA (01) | FL |
D57691 | (02) | FL |