Individual
DR. KENNETH E STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1220 E ELM ST STE 101, LIMA, OH 45804-2803
(419) 228-0570
(419) 228-0943
Mailing address
1220 E ELM ST STE 101, LIMA, OH 45804-2803
(419) 228-0570
(419) 228-0943
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
057809
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000027893
ANTHEM
—
05
—
0989757
—
OH
01
—
340008614
RAILROAD MEDICARE
—
Enumeration date
07/17/2006
Last updated
03/13/2008
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