Organization
STANLY MEDICAL SERVICES
Active
Other names
Stanly Pediatric Services at Locust
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS SCOTT FORTH (CEO)
(704) 983-8756
Entity
Organization
Contact information
Practice address
103 STANLY PKWY, STE A, LOCUST, NC 28097-7704
(704) 888-8445
(704) 888-8456
Mailing address
320 YADKIN ST, STE B, ALBEMARLE, NC 28001-3447
(704) 982-0639
(704) 983-6153
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89015PK
—
NC
Enumeration date
11/07/2005
Last updated
08/22/2020
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