Provider Demographics
NPI:1083811962
Name:STAUFFER, ELISA J (MD)
Entity Type:Individual
Prefix:DR
First Name:ELISA
Middle Name:J
Last Name:STAUFFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELISA
Other - Middle Name:J
Other - Last Name:KEEFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8110 E 32ND ST N STE 170
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2627
Mailing Address - Country:US
Mailing Address - Phone:316-330-9700
Mailing Address - Fax:316-330-9701
Practice Address - Street 1:8110 E 32ND ST N STE 170
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2627
Practice Address - Country:US
Practice Address - Phone:316-330-9700
Practice Address - Fax:316-330-9701
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK25839208000000X
NY2718392080P0207X
KS04-440742080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics