# GERARD J STANLEY JR MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790035954
- **Authorized official:** DR. GERARD JOSEPH STANLEY JR. M.D. (OWNER)
- **Authorized official phone:** (402) 884-6700

## Contact information

- **Practice address:** 2255 S 132ND ST, OMAHA, NE 68144-2573
- **Practice address phone:** (402) 884-6700
- **Practice address fax:** (402) 884-6040
- **Mailing address:** 2255 S 132ND ST, OMAHA, NE 68144-2573
- **Mailing address phone:** (402) 884-6700
- **Mailing address fax:** (402) 884-6040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/14/2012
- **Last updated:** 03/20/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 10026267000 | — | NE |
| 01 | — | 1427139294 | BCBS NE | NE |
| 05 | — | 1427139294 | — | IA |