Individual
DR. RUSSELL FOREST STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1100 E LAKE ST STE 260, TYLER, TX 75701-3359
(903) 590-5700
(903) 590-5735
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 606-6400
(903) 606-1522
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
DO.2123
AL
207V00000X
Obstetrics & Gynecology Physician
S0996
TX
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
S0996
TX
207VG0400X
Gynecology Physician
2123
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2016
Last updated
09/10/2024
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