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NPI Code Detail

MEDICARE: HERMAN PAUL STANLEY JR. PHD

MEDICARE: HERMAN PAUL STANLEY JR. PHD
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
1103T00000XPsychologistP0000000997TN

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 : 1942247937
Entity Type Code : Individual
Provider Name (Legal Business Name) : HERMAN PAUL STANLEY JR. PHD
Provider Business Mailing Address
First Line : 3150 LENOX PARK BLVD
Second Line : SUITE 214
City : MEMPHIS
State : TN
Zip : 38115-4299
Country : US
Telephone Number : 901-273-2368
Fax Number : 901-273-2351
Provider Business Practice Location Address
First Line : 3150 LENOX PARK BLVD
Second Line : SUITE 214
City : MEMPHIS
State : TN
Zip : 38115-4299
Country : US
Telephone Number : 901-273-2368
Fax Number : 901-273-2351
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 06/10/2008

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