Provider Demographics
NPI:1881739043
Name:STAUFFER, MARION V (DC)
Entity type:Individual
Prefix:DR
First Name:MARION
Middle Name:V
Last Name:STAUFFER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 E DUNKIN RD
Mailing Address - Street 2:
Mailing Address - City:CUSHING
Mailing Address - State:OK
Mailing Address - Zip Code:74023-5793
Mailing Address - Country:US
Mailing Address - Phone:918-225-7374
Mailing Address - Fax:918-225-1988
Practice Address - Street 1:1236 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CUSHING
Practice Address - State:OK
Practice Address - Zip Code:74023-3000
Practice Address - Country:US
Practice Address - Phone:918-225-1973
Practice Address - Fax:918-225-1988
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2603111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1679574628OtherGROUP NPI NUMBER
OK1679574628OtherGROUP NPI NUMBER