Dault, Stacey Louise
Dault, Stacey Louise is an individual health care provider with primary practice located at 6139 S Rural Rd Ste 102 , Tempe AZ 85283-2929. She recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as her primary health care specialty. Dault, Stacey Louise can be contacted via phone (480) 846-0688.Contact Information
Primary practice address
6139 S Rural Rd Ste 102
Tempe AZ 85283-2929
Phone: (480) 846-0688
Fax: (480) 741-8650
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 006185 | Arizona |
Profile Details
| NPI number | 1760775357 |
|---|---|
| LBN Legal business name | Dault, Stacey Louise |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 16th, 2011 |
| Last updated | Apr 9th, 2024 - about 5 months 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 | 1760775357 | NPPES |
| Arizona | MEDICAID | 030026 |
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