Individual
GEORGE PETER STACY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6420 DUTCHMANS PKWY STE 200, LOUISVILLE, KY 40205-3373
(502) 891-8300
(502) 891-8338
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 592-7743
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
28751
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64287519
—
KY
Enumeration date
07/18/2005
Last updated
03/05/2026
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