Allen, Stanley Bruce
Allen, Stanley Bruce is an individual health care provider with primary practice located at 2621 E Pinetree Blvd , Thomasville GA 31792-4840. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Allen, Stanley Bruce can be contacted via phone (229) 584-4100.Contact Information
Primary practice address
2621 E Pinetree Blvd
Thomasville GA 31792-4840
Phone: (229) 584-4100
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 001731 | Georgia |
Profile Details
| NPI number | 1326034505 |
|---|---|
| LBN Legal business name | Allen, Stanley Bruce |
| Credentials | PAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 23rd, 2005 |
| Last updated | Sep 17th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326034505 | NPPES |
| Georgia | MEDICAID | 100000109B | |
| Georgia | Other | 970029019 | |
| Georgia | Other | GRP7061 |
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