Healthcare Provider Details

I. General information

NPI: 1518687904
Provider Name (Legal Business Name): DANNY JOE STANLEY II PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOEY STANLEY PHARMD

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 E BROADWAY
NEWPORT TN
37821-2323
US

IV. Provider business mailing address

751 LEADVALE CHURCH RD
WHITE PINE TN
37890-4616
US

V. Phone/Fax

Practice location:
  • Phone: 423-623-0364
  • Fax: 423-623-7294
Mailing address:
  • Phone: 606-939-2638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number46703
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: