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Individual

DR. TY K STANSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
400 E 8TH ST, ANNISTON, AL 36207-5754
(256) 237-8527
(256) 237-0208
Mailing address
PO BOX 700, ANNISTON, AL 36202-0700
(256) 237-8527
(256) 237-0208

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16717
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000077427
AL
01
051077427
BCBS
AL
Enumeration date
12/23/2005
Last updated
02/03/2010
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