Healthcare Provider Details

I. General information

NPI: 1891629085
Provider Name (Legal Business Name): TYLER A STAFFORD PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1809 MAIN ST
FRANKLINTON LA
70438-3619
US

IV. Provider business mailing address

41601 HIGHWAY 16
FRANKLINTON LA
70438-4395
US

V. Phone/Fax

Practice location:
  • Phone: 985-515-3301
  • Fax:
Mailing address:
  • Phone: 985-515-3301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number026246
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: