Healthcare Provider Details

I. General information

NPI: 1235427170
Provider Name (Legal Business Name): CHRISTOPHER SCOTT STANLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2011
Last Update Date: 07/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6465 GREENWOOD PLAZA BLVD SUITE 300
CENTENNIAL CO
80111-4905
US

IV. Provider business mailing address

6465 GREENWOOD PLAZA BLVD SUITE 300
CENTENNIAL CO
80111-4905
US

V. Phone/Fax

Practice location:
  • Phone: 303-929-5463
  • Fax: 303-267-3332
Mailing address:
  • Phone: 303-929-5463
  • Fax: 303-267-3332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number32530
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: