Stafford, Alicia Marie

Stafford, Alicia Marie is an individual health care provider with primary practice located at 520 Mary St Ste 520 , Evansville IN 47710-1682. She recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as her primary health care specialty. Stafford, Alicia Marie can be contacted via phone (812) 424-8231.

Contact Information

Primary practice address
520 Mary St Ste 520 Evansville IN 47710-1682
Phone: (812) 424-8231
Fax: (812) 435-8794
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 01089757A Indiana

Profile Details

NPI number 1609360890
LBN Legal business name Stafford, Alicia Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2018
Last updated Mar 5th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609360890 NPPES
Indiana Other 01089757B CSR
Indiana Other 01089757A CSR
Indiana MEDICAID 300075440 CSR
Indiana MEDICAID 7100897790 CSR

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