Individual
T. MARK STANFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 CLINIC DR, MADISONVILLE, KY 42431-1661
(270) 825-7200
Mailing address
200 CLINIC DR, MADISONVILLE, KY 42431-1661
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
36298
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000392305
BCBS PROVIDER NUMBER
—
01
—
36298
LICENSE
KY
05
—
64001324
—
KY
Enumeration date
09/17/2006
Last updated
01/03/2017
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