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NPI Code Detail

MEDICARE: JOHN E STANILAND MD

MEDICARE:   JOHN E STANILAND  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianJ9360TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2080194030OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447264908
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN E STANILAND MD
Provider Business Mailing Address
First Line : PO BOX 961205
Second Line :
City : FORT WORTH
State : TX
Zip : 76161-1205
Country : US
Telephone Number : 817-740-8400
Fax Number : 817-433-5119
Provider Business Practice Location Address
First Line : 6100 HARRIS PKWY
Second Line : SUITE 340
City : FORT WORTH
State : TX
Zip : 76132-4133
Country : US
Telephone Number : 817-433-5111
Fax Number : 817-433-5119
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2006
Last Update Date : 09/30/2011

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Directions to “ JOHN E STANILAND MD” Practice Location

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