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NPI Code Detail

MEDICARE: MR. WARREN J. STOFFEY PA-C

MEDICARE: MR. WARREN J. STOFFEY PA-C
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
1363A00000XPhysician AssistantPA501TN

General Provider Information

NPI Number : 1538168570
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WARREN J. STOFFEY PA-C
Provider Business Mailing Address
First Line : 2703 CROWNE POINTE DR
Second Line :
City : MURFREESBORO
State : TN
Zip : 37130-6654
Country : US
Telephone Number : 615-898-0233
Fax Number :
Provider Business Practice Location Address
First Line : 1559 SPARTA ST
Second Line :
City : MCMINNVILLE
State : TN
Zip : 37110-1316
Country : US
Telephone Number : 931-815-4280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 03/24/2010

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