| Doctor Name: | MR. NATHAN STAFFORD |
| NPI Number: | 1811127236 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 243 Curtiss Rd Ste 100 Barksdale Afb, LA - 711102425 |
| Business Phone Number: | 3184566555 |
| Business Fax Number: | |
| Mailing Address: | 243 Curtiss Rd Ste 100, BARKSDALE AFB |
| State: | LA |
| Postal Code: | 711102425 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/20/2009 |
| NPI Last Update Date: | 05/18/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |