Healthcare Provider Details

I. General information

NPI: 1588870224
Provider Name (Legal Business Name): STANLEY NEIL THORNTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 04/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 AIRPORT BLVD SUITE D-330
MOBILE AL
36608-6705
US

IV. Provider business mailing address

6701 AIRPORT BLVD SUITE D-330
MOBILE AL
36608-6705
US

V. Phone/Fax

Practice location:
  • Phone: 251-607-9797
  • Fax: 251-639-0940
Mailing address:
  • Phone: 251-607-9797
  • Fax: 251-639-0940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD200168
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number15460
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number30866
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: