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General NPI Number Information
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NPI Number | 1497243695
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Entity Type | Individual
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Provider Name | ANTOINE E. STANFORD MBA HCM, HAD
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Gender | Male
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Dates
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Enumeration Date | 04/24/2018
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 13940 W MEEKER BLVD
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-4492
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Country | US
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Telephone | 480-825-6115
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Fax |
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Provider Business Mailing Address
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Address Line | 17672 W MARICOPA ST
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City | GOODYEAR
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State | AZ
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Zip | 85338-4705
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Country | US
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Telephone | 623-570-7831
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HADE9354
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License Number State | AZ
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