Healthcare Provider Details

I. General information

NPI: 1760207294
Provider Name (Legal Business Name): WILLIAM DAVID STANTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2817 ROCK MERRITT AVENUE 2ND FLOOR CLINIC MALL
FORT BRAGG NC
28310-4445
US

IV. Provider business mailing address

24 GLOBEMASTER AVE
FORT BRAGG NC
28307-1530
US

V. Phone/Fax

Practice location:
  • Phone: 910-907-7405
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2026-04904
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: