Clyde McClellan Stauffer, DO
Surgery in Fort Smith, AR. Individual provider (NPI-1).
NPI number1669909255
StatusActive
Last updated in NPPESAug 4, 2022
Details
- NPI
- 1669909255
- Entity type
- Individual (NPI-1)
- Name
- Clyde McClellan Stauffer
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 15, 2017
- Certification date
- Aug 4, 2022
- Last updated
- Aug 4, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | E-15156 | AR | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | 5101022979 | MI |
Practice location
7001 Rogers Ave Ste 600Fort Smith, AR 72903-4073
Phone 479-573-3101 · Fax 479-573-3102
Mailing address
7001 Rogers Ave Ste 600Fort Smith, AR 72903-4073
Phone 479-573-3101 · Fax 479-573-3102
Other practice locations
205 N East Ave
Jackson, MI 49201-1753
Jackson, MI 49201-1753
Phone 517-205-7182 · Fax 517-205-7050
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