Basic Information
| Provider Information | |||||||||
| NPI: | 1790713139 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STAUFFER | ||||||||
| FirstName: | ARLEN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12230 LIONESS WAY | ||||||||
| Address2: | |||||||||
| City: | PARKER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801345603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7206449355 | ||||||||
| FaxNumber: | 7205231654 | ||||||||
| Practice Location | |||||||||
| Address1: | 12230 LIONESS WAY | ||||||||
| Address2: | |||||||||
| City: | PARKER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801345603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7206449355 | ||||||||
| FaxNumber: | 7205231654 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2006 | ||||||||
| LastUpdateDate: | 03/24/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QH0002X | DR.0066576 | CO | N | Allopathic & Osteopathic Physicians | Family Medicine | Hospice and Palliative Medicine | 207Q00000X | DR.0066576 | CO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1790713139 | 01 | FL | TRICARE | OTHER | 067499100 | 05 | FL | MEDICAID | 64470 | 01 | FL | BLUE CROSS BLUE SHIELD OF FLORIDA | OTHER |