Individual
DR. ANNA FAYE STANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
120 SAM WALTON DR, RUSSELLVILLE, KY 42276-9311
(270) 726-8283
(270) 726-9842
Mailing address
1102 BROOKHAVEN AVE, RUSSELLVILLE, KY 42276-1020
(270) 726-8283
(270) 726-9842
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1476DT
KY
152W00000X
Optometrist
18002536B
IN
152W00000X
Optometrist
464
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77340438
—
KY
01
—
P00396722
RAILROAD MEDICARE
KY
Enumeration date
01/18/2006
Last updated
03/11/2015
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