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General NPI Number Information
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NPI Number | 1063426948
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Entity Type | Individual
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Provider Name | WILLIAM SCOTT STANO DPM
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Gender | Male
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 220 W JEFFERSON ST
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City | BOISE
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State | ID
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Zip | 83702-6044
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Country | US
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Telephone | 208-343-8907
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Fax | 208-343-9161
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Provider Business Mailing Address
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Address Line | 220 W JEFFERSON ST
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City | BOISE
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State | ID
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Zip | 83702-6044
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Country | US
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Telephone | 208-343-8907
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Fax | 208-343-9161
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | P114
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License Number State | ID
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