Provider Demographics
NPI:1700889763
Name:STAGGS, STEPHEN M (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:M
Last Name:STAGGS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:343 FRANKLIN RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5250
Mailing Address - Country:US
Mailing Address - Phone:615-373-1255
Mailing Address - Fax:615-371-9040
Practice Address - Street 1:343 FRANKLIN RD
Practice Address - Street 2:STE 106
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5250
Practice Address - Country:US
Practice Address - Phone:615-373-1255
Practice Address - Fax:615-371-9040
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2021-04-29
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Provider Licenses
StateLicense IDTaxonomies
MEMD24521207V00000X
MEEL211024207V00000X
RIMD17443207V00000X
TN11790207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB04222Medicare UPIN