MEDICARE: JOHN R STANFORD M.D.

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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	01028422A	IN

General Provider Information

NPI Number	:	1639171499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN R STANFORD M.D.

Provider Business Mailing Address
First Line	:	2414 E STATE BLVD
Second Line	:	CAREW BUILDING #1, SUITE 201
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-4760
Country	:	US
Telephone Number	:	260-482-4741
Fax Number	:	260-482-3051

Provider Business Practice Location Address
First Line	:	2414 E STATE BLVD
Second Line	:	CAREW BUILDING #1, SUITE 201
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-4760
Country	:	US
Telephone Number	:	260-482-4741
Fax Number	:	260-482-3051

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1972594968 — ALLIED PHYSICIANS INC., D/B/A INDIANA OHIO HEART
Practice Location Address:

2414 E STATE BLVD , CAREW BUILDING
FORT WAYNE, IN
46805-4760

Practice Phone: 260-482-4741
Practice Fax: 260-482-3051

1942352802 — JULIE R. STACKHOUSE CNM
Practice Location Address:

2414 E STATE BLVD , SUITE 101
FORT WAYNE, IN
46805-4760

Practice Phone: 260-422-7455
Practice Fax: 260-422-0086

1558529933 — MRS. CHERYL AMANDA GRATZ LSW
Practice Location Address:

2414 E STATE BLVD , SUITE 304
FORT WAYNE, IN
46805-4760

Practice Phone: 260-373-8060
Practice Fax: 260-373-8042

1831354471 — NORTHEAST OBSTETRICS & GYNECOLOGY, LLC
Practice Location Address:

2414 E STATE BLVD , SUITE 101
FORT WAYNE, IN
46805-4760

Practice Phone: 260-422-7455
Practice Fax: 260-422-0086

1588682967 — BEATRICE G KUTZLER MD
Practice Location Address:

4760 BARWICK DR STE A
FORT WORTH, TX
76132-1529

Practice Phone: 817-346-9533
Practice Fax: 817-346-9788

1912063371 — TEXAS HEALTH CARE, P.L.L.C.
Practice Location Address:

4760 BARWICK DRIVE, , SUITE C
FORT WORTH, TX
76132-1529

Practice Phone: 817-346-9533
Practice Fax: 817-346-9788

Directions to “ JOHN R STANFORD M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.