Provider Demographics
NPI:1740418128
Name:GAFFORD FAMILY MEDICINE
Entity Type:Organization
Organization Name:GAFFORD FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-433-7778
Mailing Address - Street 1:2320 THORNTON TAYLOR PKWY
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37334-3630
Mailing Address - Country:US
Mailing Address - Phone:931-433-7778
Mailing Address - Fax:931-433-7712
Practice Address - Street 1:2320 THORNTON TAYLOR PKWY
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37334-3630
Practice Address - Country:US
Practice Address - Phone:931-433-7778
Practice Address - Fax:931-433-7712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-24
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty