Healthcare Provider Details

I. General information

NPI: 1891490660
Provider Name (Legal Business Name): CAROLINE FRANCES STAFFORD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 07/12/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 W HIGHWAY 30
GONZALES LA
70737-5004
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 225-621-2975
  • Fax: 225-621-2931
Mailing address:
  • Phone: 225-621-2975
  • Fax: 225-765-9196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number351132
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: