Healthcare Provider Details

I. General information

NPI: 1255336194
Provider Name (Legal Business Name): STANLEY STEPHEN JOSEF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 04/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HEARTCENTER LN
HOT SPRINGS AR
71913-6351
US

IV. Provider business mailing address

PO BOX 21850
HOT SPRINGS AR
71903-1850
US

V. Phone/Fax

Practice location:
  • Phone: 501-624-6641
  • Fax: 501-321-4890
Mailing address:
  • Phone: 501-624-6641
  • Fax: 501-321-4890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberE-0677
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: