Individual
DR. ROGER DALE STANMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7583 WALL TRIANA HWY, MADISON, AL 35757-8327
(256) 547-6119
(256) 546-2981
Mailing address
PO BOX 303, GADSDEN, AL 35902-0303
(256) 547-6119
(256) 546-2981
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00013106
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009932569
—
AL
01
—
3002
NEIC SITE ID, NSF BA0-7
AL
01
—
3015
NEIC SITE ID
AL
01
—
51001283
BLUE CROSS BLUE SHIELD
AL
01
—
51532050
BLUE CROSS BLUE SHIELD
AL
Enumeration date
06/01/2006
Last updated
03/07/2023
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