Individual
MR. MARTIN H STANCIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
125 KING AVE, ATHENS, GA 30606-6734
(706) 549-1663
(706) 546-8792
Mailing address
1765 OLD WEST BROAD ST BLDG 2-200, ATHENS, GA 30606-2887
(706) 549-1663
(706) 546-8792
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6057
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12328584
CAQH NUMBER
—
Enumeration date
02/07/2011
Last updated
03/11/2024
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