NPI 1336193200

Jon L Stanford, MD

Practitioner Surgery Physician Carrollton, GA

Practice location

Address: 119 Ambulance Dr # Dt Suite 202, Carrollton, GA 30117-3857
Phone: (770) 834-3336
Fax: (770) 832-2331
Mailing address: 157 Clinic Ave Suite 302, Carrollton, GA 30117-4454

Registered specialties (2)

Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208600000X Licence 065186 (GA)

Other Surgery providers in Georgia →

Specialist

Other Service Providers Taxonomy 174400000X Licence 24016 (SC)

Other Specialist providers in Georgia →

Registry record

NPI: 1336193200
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 May 2006
Record last updated: 8 Aug 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.