Provider Demographics
NPI:1417211665
Name:STANFORD, JAMES M (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:STANFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:202 S FRISCO STREET
Mailing Address - Street 2:COMANCHE COUNTY HOSPITAL
Mailing Address - City:COLDWATER
Mailing Address - State:KS
Mailing Address - Zip Code:67029
Mailing Address - Country:US
Mailing Address - Phone:620-582-2144
Mailing Address - Fax:620-582-2572
Practice Address - Street 1:202 S FRISCO ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:KS
Practice Address - Zip Code:67029-9101
Practice Address - Country:US
Practice Address - Phone:620-582-2144
Practice Address - Fax:620-582-2572
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-37374208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice