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General NPI Number Information
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NPI Number | 1619207289
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Entity Type | Organization
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Legal Business Name | DAVID J STANSFIELD DO LLC
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Dates
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Enumeration Date | 01/05/2010
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Last Update Date | 01/05/2010
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Provider Practice Location Address
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Address Line | 10279 BUSINESS 21
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City | HILLSBORO
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State | MO
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Zip | 63050-3598
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Country | US
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Telephone | 636-789-3941
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Fax | 636-789-5603
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Provider Business Mailing Address
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Address Line | 10279 BUSINESS 21
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City | HILLSBORO
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State | MO
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Zip | 63050-3598
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Country | US
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Telephone | 636-789-3941
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Fax | 636-789-5603
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | KATHLEEN L STANSFIELD
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Credential |
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Telephone | 636-789-3941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R1304
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License Number State | MO
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