Provider Demographics
NPI:1669162541
Name:SANDEFORD, NAPOLEON TIMOTHY
Entity type:Individual
Prefix:
First Name:NAPOLEON
Middle Name:TIMOTHY
Last Name:SANDEFORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3123 W 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-4804
Mailing Address - Country:US
Mailing Address - Phone:870-413-2157
Mailing Address - Fax:
Practice Address - Street 1:3123 W 28TH AVE
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-4804
Practice Address - Country:US
Practice Address - Phone:870-413-2157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No171WH0202XOther Service ProvidersContractorHome Modifications
No172V00000XOther Service ProvidersCommunity Health Worker
No247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information
No372500000XNursing Service Related ProvidersChore Provider
No374700000XNursing Service Related ProvidersTechnician