Healthcare Provider Details

I. General information

NPI: 1487066478
Provider Name (Legal Business Name): STONY FIELD MANAGEMENT PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2014
Last Update Date: 05/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2255 S 132ND ST # 100
OMAHA NE
68144-2573
US

IV. Provider business mailing address

2255 S 132ND ST # 100
OMAHA NE
68144-2573
US

V. Phone/Fax

Practice location:
  • Phone: 402-884-6700
  • Fax: 402-502-8202
Mailing address:
  • Phone: 402-884-6700
  • Fax: 402-502-8202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STANLEY J GERARD JR.
Title or Position: OWNER
Credential: MD
Phone: 402-884-6700