NPIMap

Organization Active NPI

Bruce a. Stafford, DO, PC

  • Family Medicine Physician
  • Choctaw, OK
National Provider Identifier
1639267362
Registry record updated Sep 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3919 Issued in OK
Legal business name
BRUCE A. STAFFORD, DO, PC
Doing business as
Bruce A. Stafford, DO, PC
Practice address
15809 NE 23Rd St
Choctaw, OK 73020-8428
Phone
(405) 390-4280
Fax
(405) 390-4282
NPI assigned
Oct 10, 2006
Last updated
Sep 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bruce A. Stafford, DONPI 1861479255
Title
Physician
Phone
(405) 390-4280

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3919 OK Primary

Addresses

Primary practice location

15809 NE 23Rd St
Choctaw, OK 73020-8428

Mailing address

15809 NE 23Rd St
Choctaw, OK 73020-8428
Phone (405) 390-4280

Other identifiers 1

IdentifierTypeStateIssuer
200019750AMedicaidOK

Other names 1

  • Bruce A. Stafford, DO, PC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222732800000",
    "number": "1639267362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15809 NE 23RD ST",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730208428",
            "telephone_number": "405-390-4280",
            "fax_number": "405-390-4282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15809 NE 23RD ST",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730208428",
            "telephone_number": "405-390-4280",
            "fax_number": "405-390-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE A. STAFFORD, DO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-09-30",
        "status": "A",
        "authorized_official_last_name": "STAFFORD",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "405-390-4280",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "3919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200019750A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bruce A. Stafford, DO, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Choctaw, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.