Organization
JON S STANCIL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON SCOTT STANCIL DPM (OWNER)
(252) 439-1150
Entity
Organization
Contact information
Practice address
1432 E FIRE TOWER RD, GREENVILLE, NC 27858-4105
(252) 439-1150
(252) 439-1152
Mailing address
1432 E FIRE TOWER RD, GREENVILLE, NC 27858-4105
(252) 439-1150
(252) 439-1152
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
412
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0801A
BCBS
NC
05
—
79-0801A
—
NC
Enumeration date
03/10/2008
Last updated
03/10/2008
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