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General NPI Number Information
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NPI Number | 1972691541
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Entity Type | Individual
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Provider Name | WILLIAM CLAYTON STAFFORD M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 103 HILLTOPPER DR
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City | STANFORD
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State | KY
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Zip | 40484-1073
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Country | US
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Telephone | 270-963-6011
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Fax |
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Provider Business Mailing Address
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Address Line | 103 HILLTOPPER DR
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City | STANFORD
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State | KY
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Zip | 40484-1073
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Country | US
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Telephone | 270-963-6011
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 125050533
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 41705
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 41705
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License Number State | KY
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