Individual
MR. STANLEY J CROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1905 W 19TH ST, MOUNTAIN GROVE, MO 65711-1287
(417) 926-1770
(417) 926-1785
Mailing address
1137 INDEPENDENCE DR, WEST PLAINS, MO 65775-4221
(417) 255-8464
(417) 255-9741
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
104161
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336233584
—
MO
01
—
26D2006074
CLIA
MO
Enumeration date
10/03/2006
Last updated
09/21/2016
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