MEDICARE: STANLY MEDICAL SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073594305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STANLY MEDICAL SERVICES

Provider Business Mailing Address
First Line	:	320 YADKIN ST
Second Line	:	SUITE B
City	:	ALBEMARLE
State	:	NC
Zip	:	28001-3447
Country	:	US
Telephone Number	:	704-982-0639
Fax Number	:	704-983-6153

Provider Business Practice Location Address
First Line	:	103 STANLY PKWY
Second Line	:	SUITE B
City	:	LOCUST
State	:	NC
Zip	:	28097-7704
Country	:	US
Telephone Number	:	704-888-8581
Fax Number	:	704-888-8488

Authorized Official
Title or Position	:	CEO
Name	:	DOUGLAS SCOTT FORTH
Credential	:
Telephone Number	:	704-983-8756

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	08/22/2020

Similar Medicare Providers

1821079963 — STANLY MEDICAL SERVICES
Practice Location Address:

103 STANLY PKWY , STE A
LOCUST, NC
28097-7704

Practice Phone: 704-888-8445
Practice Fax: 704-888-8456

1124294194 — WEST STANLY IMAGING LLC
Practice Location Address:

103 STANLY PKWY , SUITE E
LOCUST, NC
28097-7704

Practice Phone: 704-781-0003
Practice Fax:

1942209499 — KRISTINA MARIE WILSON FNP
Practice Location Address:

123 PROFESSIONAL PARK DR
LOCUST, NC
28097-7712

Practice Phone: 704-403-6760
Practice Fax:

1649268459 — DR. RICARDO VARGAS M.D.
Practice Location Address:

236 MARKET ST , SUITE 110
LOCUST, NC
28097-9437

Practice Phone: 704-384-9590
Practice Fax: 704-384-9591

1902894041 — DR. JASON F BAKER DDS
Practice Location Address:

236 MARKET ST , SUITE 200
LOCUST, NC
28097-9438

Practice Phone: 704-781-0500
Practice Fax: 704-781-0555

1871574921 — STANLY MEDICAL SERVICES
Practice Location Address:

103 STANLY PKWY , SUITE A
LOCUST, NC
28097-7710

Practice Phone: 704-888-0580
Practice Fax: 704-888-0602

Directions to “STANLY MEDICAL SERVICES ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.