Provider Demographics
NPI:1700844321
Name:TAFOR, STEPHEN N (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:N
Last Name:TAFOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 PRESTON CT
Mailing Address - Street 2:STE 103
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-5772
Mailing Address - Country:US
Mailing Address - Phone:478-745-2385
Mailing Address - Fax:478-745-1225
Practice Address - Street 1:101 PRESTON CT
Practice Address - Street 2:SUITE 103
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-5772
Practice Address - Country:US
Practice Address - Phone:478-745-2385
Practice Address - Fax:478-745-1225
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA57329208VP0014X, 208VP0000X, 207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA781749283EMedicaid
GA57329OtherGA MEDICAL LICENSE
GA781749283DMedicaid
GA781749283DMedicaid