Organization
ANNA FAYE STANLEY OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNA FAYE STANLEY O.D. (OWNER)
(270) 726-8283
Entity
Organization
Contact information
Practice address
120 SAM WALTON DR, VISION CENTER, RUSSELLVILLE, KY 42276-9311
(270) 726-8283
Mailing address
1102 BROOKHAVEN AVE, RUSSELLVILLE, KY 42276-1020
(270) 776-8127
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1476DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77340438
—
KY
01
—
DF8467
RAILROAD MEDICARE
KY
Enumeration date
08/09/2007
Last updated
10/02/2014
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