MEDICARE: JON TURNER STAUFFER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	MD27231	ME
2	207RG0100X	Gastroenterology Physician	DR.0028979	CO

General Provider Information

NPI Number	:	1194720177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JON TURNER STAUFFER M.D.

Provider Business Mailing Address
First Line	:	104 WALNUT ST
Second Line	:
City	:	ROCKPORT
State	:	IN
Zip	:	47635-1356
Country	:	US
Telephone Number	:	229-221-8057
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 GLEN COVE DR STE 10
Second Line	:
City	:	ROCKPORT
State	:	ME
Zip	:	04856-4235
Country	:	US
Telephone Number	:	207-301-5970
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	09/14/2023

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