Individual
DR. JONATHAN MICHAEL STANFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
604 BRANTLEY ST, OPP, AL 36467-1742
(334) 394-4472
(334) 493-9849
Mailing address
604 BRANTLEY ST, P O BOX 280, OPP, AL 36467-1742
(334) 394-4472
(334) 493-9849
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21062
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35324
—
AL
01
—
51035324
BLUE CROSS BLUE SHIELD
AL
Enumeration date
11/01/2006
Last updated
10/31/2007
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