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General NPI Number Information
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NPI Number | 1902067515
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Entity Type | Individual
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Provider Name | AMY MARIE STAFFORD MD
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Gender | Female
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 04/05/2023
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Provider Practice Location Address
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Address Line | 200 ABRAHAM FLEXNER WAY
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City | LOUISVILLE
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State | KY
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Zip | 40202-2877
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Country | US
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Telephone | 502-587-4404
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Fax | 502-587-4156
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Provider Business Mailing Address
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Address Line | 1611 S UTICA AVE STE 217
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City | TULSA
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State | OK
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Zip | 74104-4909
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Country | US
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Telephone | 918-744-3664
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Fax | 918-748-7688
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | P2537
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 29337
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 57445
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License Number State | KY
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