Mr. Earl Raymond Staddon
Family Doctor - Geriatric Medicine
119 S Main St
Union
, Ohio 45322-3300
Mr. Earl Raymond Staddon
Family Doctor - Geriatric Medicine
119 S Main St
Union
, Ohio 45322-3300
(937) 836-7117
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About
Features
Specialties
- Family Doctor - Geriatric Medicine
Languages spoken
- English
Location
First Address
- Mr. Earl Raymond Staddon
- 119 S Main St
- Union, OH
- Zip : 45322-3300
- Fax : (937) 836-7117
- Phone : (937) 836-2309
Second Address
- Mr. Earl Raymond Staddon
- 119 S Main St
- Union, OH
- Zip : 45322-3300
- Fax : (937) 836-7117
- Phone : (937) 836-2309
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QG0300X | Family Doctor - Geriatric Medicine | 340019485 | OH |
National Provider Identifier
| NPI | 1346226677 |
|---|---|
| Provider Name | Mr. Earl Raymond Staddon |
| First Address | Union, OH 45322-3300 |
| Second Address | Union, OH 45322-3300 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/12/2005 |
| Last Update Date | 12/09/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0159046 | (05) | OH |
| D89742 | (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.