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General NPI Number Information
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NPI Number | 1215964689
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Entity Type | Individual
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Provider Name | STANLEY H STANCIL M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 07/24/2018
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Provider Practice Location Address
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Address Line | 2900 16TH ST
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City | BEDFORD
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State | IN
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Zip | 47421-3510
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Country | US
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Telephone | 812-275-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 330 N WABASH AVE STE 475
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City | MARION
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State | IN
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Zip | 46952-2685
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Country | US
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Telephone | 765-661-3522
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | G0158
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 4301081102
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | 4301081102
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 01060589A
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License Number State | IN
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