MEDICARE: VERNON STANLEY MD

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	207P00000X	Emergency Medicine Physician	10421	WV

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	:	1437216702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERNON STANLEY MD

Provider Business Mailing Address
First Line	:	1431 CENTERPOINT BLVD
Second Line	:	SUITE 100
City	:	KNOXVILLE
State	:	TN
Zip	:	37932-1984
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	430 MAIN ST W
Second Line	:
City	:	OAK HILL
State	:	WV
Zip	:	25901-3414
Country	:	US
Telephone Number	:	304-469-8635
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	07/09/2007

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Directions to “ VERNON STANLEY MD” Practice Location

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