MEDICARE: DR. JAY S STAUFFER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	H4725	TX

General Provider Information

NPI Number	:	1144225756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY S STAUFFER MD

Provider Business Mailing Address
First Line	:	PO BOX 2409
Second Line	:
City	:	FREDERICKSBURG
State	:	TX
Zip	:	78624-1906
Country	:	US
Telephone Number	:	830-997-8833
Fax Number	:	830-990-8725

Provider Business Practice Location Address
First Line	:	1009 S MILAM ST
Second Line	:	STE 4
City	:	FREDERICKSBURG
State	:	TX
Zip	:	78624-4578
Country	:	US
Telephone Number	:	830-997-8833
Fax Number	:	830-990-8725

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	01/15/2026

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