MEDICARE: JANET FLORENCE STASTNY DO

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	D00000001291	TN
2	207ZC0500X	Cytopathology Physician	D00000001291	TN

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	:	1649254574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET FLORENCE STASTNY DO

Provider Business Mailing Address
First Line	:	2400 SUSANNAH ST STE A
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37601-1730
Country	:	US
Telephone Number	:	423-283-4734
Fax Number	:	423-283-4736

Provider Business Practice Location Address
First Line	:	2400 SUSANNAH ST STE A
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37601-1730
Country	:	US
Telephone Number	:	423-283-4734
Fax Number	:	423-283-4736

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

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	03/14/2019

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Directions to “ JANET FLORENCE STASTNY DO” Practice Location

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