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Individual

DR. BRIAN A STANTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
900 W ASH ST, DEMING, NM 88030-4000
(575) 546-5800
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
(660) 826-5960
(660) 826-4852

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD2012-0248
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100248370A
OK
01
348047100
DEPT OF LABOR
OK
01
5860324
AETNA
OK
01
P00089961
RAILROAD MEDICARE
OK
Enumeration date
10/12/2005
Last updated
09/11/2012
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