Healthcare Provider Details

I. General information

NPI: 1124076294
Provider Name (Legal Business Name): JAMES HARRY STAFFORD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 MEDI PARK DR
AMARILLO TX
79106-2187
US

IV. Provider business mailing address

PO BOX 51800
AMARILLO TX
79159-1800
US

V. Phone/Fax

Practice location:
  • Phone: 806-355-9447
  • Fax: 806-356-9251
Mailing address:
  • Phone: 806-355-9447
  • Fax: 806-356-9251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number18173C
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberJ2808
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: