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Individual

DR. JOHN G. STANSBURY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11 HUNT CLUB PLZ, RIDGELEY, WV 26753-5213
(304) 726-4501
(304) 726-4051
Mailing address
11 HUNT CLUB PLZ, RIDGELEY, WV 26753-5213
(304) 726-4501
(304) 726-4051

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
15011
WV
207P00000X
Emergency Medicine Physician
D23765
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000508728
MT. STATE BC BS
WV
05
0049933000
WV
01
930010527
TRAVELERS MEDICARE
01
A052JG 42142702
CARE FIRST BC BS
MD
01
E458 0008
BLUE CHOICE
DC
Enumeration date
07/20/2005
Last updated
11/21/2009
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