Healthcare Provider Details

I. General information

NPI: 1760585210
Provider Name (Legal Business Name): STANLEY E HANDSHY, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 05/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 S MAIN ST
ERIE KS
66733-1439
US

IV. Provider business mailing address

324 S MAIN ST
ERIE KS
66733-1439
US

V. Phone/Fax

Practice location:
  • Phone: 620-244-3291
  • Fax: 620-244-5458
Mailing address:
  • Phone: 620-244-3291
  • Fax: 620-244-5458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License Number04-18856
License Number StateKS

VIII. Authorized Official

Name: DR. STANLEY E HANDSHY
Title or Position: OWNER
Credential: M.D.
Phone: 620-244-3291