Individual
MR. PHILLIP TYLER STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
1118 ROSS CLARK CIR, DOTHAN, AL 36301-3001
(334) 793-8111
Mailing address
1600 KEATING RD, DOTHAN, AL 36303-2702
(334) 701-8240
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-126879
AL
Other
Enumeration date
01/13/2017
Last updated
01/13/2017
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