Individual
SKYLAR P STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
510 PETER PAN RD, INDEPENDENCE, KS 67301-7301
(620) 332-2000
Mailing address
510 PETER PAN RD, INDEPENDENCE, KS 67301-7301
(620) 577-4310
(620) 577-4312
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-47487
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/16/2020
Last updated
09/15/2025
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