Provider Demographics
NPI:1124108238
Name:STAUFFER, JOHN GARTH (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:GARTH
Last Name:STAUFFER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2515 E GLENN AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-6453
Mailing Address - Country:US
Mailing Address - Phone:334-821-7788
Mailing Address - Fax:334-821-7555
Practice Address - Street 1:2515 E GLENN AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-6453
Practice Address - Country:US
Practice Address - Phone:334-821-7788
Practice Address - Fax:334-821-7555
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ALAL110582083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC72829Medicare UPIN