Individual
DR. KEITH L STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4802 S 109TH EAST AVE, TULSA, OK 74146-5822
(918) 392-1400
(918) 392-1488
Mailing address
4802 S 109TH E AVENUE, TULSA, OK 74146
(918) 392-1400
(918) 392-1488
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
15232
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00155592
RAILROAD MEDICARE
OK
Enumeration date
03/14/2006
Last updated
11/01/2007
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