Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | MD036648E | PA |
NPI | 1134168230 |
---|---|
Provider Name | Dr. James D Stauffer |
First Address | Lebanon, PA 17042-7529 |
Second Address | Lebanon, PA 17042-7529 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C34811 | (02) | PA |