MRS. ALICIA MARIE STAFFORD MD NPI 1609360890

NPI Information

NPI: 1609360890
Provider Name: MRS. ALICIA MARIE STAFFORD, MD
Classification: Surgery - 2086S0129X
Entity Type: Individual

Specialization: Vascular Surgery

PECOS Registration: Yes

Address:
520 MARY ST STE 520
EVANSVILLE, IN
ZIP 47710
Phone: (812) 424-8231
Get Directions

MRS. Alicia Marie Stafford, MD is a vascular surgery surgery in Evansville, IN with 6 years of experience. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. MRS. Alicia Marie Stafford, MD NPI is 1609360890. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2018

The provider's business location address is:

520 MARY ST STE 520
EVANSVILLE, IN
ZIP 47710-682
Phone: (812) 424-8231
Fax: (812) 435-8794

The NPI 1609360890 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/20/2018 and was last updated on 3/5/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0129X	Surgery	Vascular Surgery	01089757A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01089757B	OTHER	INDIANA	CSR
2	01089757A	OTHER	INDIANA	INDIANA STATE LICENSE
3	300075440	MEDICAID	INDIANA
4	7100897790	MEDICAID	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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