Healthcare Provider Details

I. General information

NPI: 1295778280
Provider Name (Legal Business Name): ROBERT J STANLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 05/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 FISH HATCHERY RD DEAN MEDICAL CENTER
MADISON WI
53715-1911
US

IV. Provider business mailing address

1313 FISH HATCHERY RD DEAN MEDICAL CENTER
MADISON WI
53715-1911
US

V. Phone/Fax

Practice location:
  • Phone: 608-252-8000
  • Fax: 608-252-8245
Mailing address:
  • Phone: 608-252-8000
  • Fax: 608-252-8245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number29109-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: