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General NPI Number Information
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NPI Number | 1023142817
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Entity Type | Individual
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Provider Name | GEORGE TIMOTHY STAFFORD III M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 08/13/2009
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Provider Practice Location Address
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Address Line | 5800 BLUE SPRUCE AVE
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City | ALAMOSA
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State | CO
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Zip | 81101-9738
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Country | US
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Telephone | 719-589-0371
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Fax | 719-589-0371
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Provider Business Mailing Address
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Address Line | 5800 BLUE SPRUCE AVE
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City | ALAMOSA
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State | CO
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Zip | 81101-9738
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Country | US
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Telephone | 719-589-0371
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Fax | 719-589-0371
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 37393
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 3542
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 3235A
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License Number State | WY
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 8440
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License Number State | MT
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