Individual
JOHN L STANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
980 PROFESSIONAL PARK DR, SUITE A, CLARKSVILLE, TN 37040-5251
(931) 905-1001
(931) 905-0410
Mailing address
3024 BUSINESS PARK CIR, GOODLETTSVILLE, TN 37072-3132
(615) 851-6033
(615) 296-9935
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD28572
TN
207X00000X
Orthopaedic Surgery Physician
Primary
MD28572
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3807449
—
TN
01
—
64926090
KENTUCKY MEDICAID
KY
Enumeration date
05/24/2005
Last updated
04/30/2015
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