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Individual
CORY M STANLEY
Active
Individual
CORY M STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-01166
NC
363A00000X
Physician Assistant
005034
GA
363A00000X
Physician Assistant
Primary
PA9116822
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01061992
AMERIGROUP
GA
01
—
0580PA
MEDICAID ID FOR URGENTONE
SC
01
—
511I970040
MEDICARE ID FOR URGENTONE
GA
05
—
567447065
—
GA
05
—
567447065A
—
GA
05
—
567447065B
—
GA
05
—
567447065C
—
GA
05
—
567447065D
—
GA
01
—
567447065E
MEDICAID ID FOR URGENTONE
GA
01
—
567447065F
MEDICAID ID FOR URGENTONE
GA
01
—
GPA892
MEDICAID GROUP ID FOR URGENTONE
SC
01
—
GPA9002
MEDICAID GROUP ID FOR URGENTONE
SC
01
—
P00441750
RR MEDICARE ID FOR URGENTONE
GA
Enumeration date
03/30/2007
Last updated
05/09/2024
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