MEDICARE: ALFRED W.H. STANLEY JR. M.D.

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	207RC0000X	Cardiovascular Disease Physician	5603	AL

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
2	051120884	OTHER	AL	BCBS
3	051120885	OTHER	AL	BCBS
4	051120887	OTHER	AL	BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	051120886	OTHER	AL	BCBS
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	C78714	OTHER	AL	VIVA

General Provider Information

NPI Number	:	1821093790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALFRED W.H. STANLEY JR. M.D.

Provider Business Mailing Address
First Line	:	2022 BROOKWOOD MEDICAL CTR DR
Second Line	:	ACC - SUITE 415
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-6808
Country	:	US
Telephone Number	:	205-250-6964
Fax Number	:	205-250-8916

Provider Business Practice Location Address
First Line	:	2022 BROOKWOOD MEDICAL CTR DR
Second Line	:	ACC - SUITE 415
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-6808
Country	:	US
Telephone Number	:	205-250-6964
Fax Number	:	205-250-8916

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	02/25/2013

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