Stanton, Thaddeus Michael

Stanton, Thaddeus Michael is an individual health care provider with primary practice located at 525 Western Ave Suite 203, Conway AR 72034-4967. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Stanton, Thaddeus Michael can be contacted via phone (501) 327-4828.

Contact Information

Primary practice address
525 Western Ave Suite 203 Conway AR 72034-4967
Phone: (501) 327-4828
Fax: (501) 327-6899
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X C6890 Arkansas

Profile Details

NPI number 1053313056
LBN Legal business name Stanton, Thaddeus Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2005
Last updated Nov 18th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053313056 NPPES
Arkansas Other 02009881 MEDICARE RAILROAD
Arkansas Other 4339027 MEDICARE RAILROAD
Arkansas MEDICAID 111393001 MEDICARE RAILROAD
Arkansas Other 15289000000 MEDICARE RAILROAD

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