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Individual
JOHN DOUGLAS STACEY
Active
Individual
JOHN DOUGLAS STACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
O-0808
ID
207X00000X
Orthopaedic Surgery Physician
Primary
OT017816
PA
208D00000X
General Practice Physician
O-0808
ID
Other
Enumeration date
05/15/2013
Last updated
04/06/2026
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