Smith, Stanley R
Smith, Stanley R is an individual health care provider with primary practice located at 17310 Wright St Ste 103 , Omaha NE 68130-2405. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Smith, Stanley R can be contacted via phone (833) 228-6889.Contact Information
Primary practice address
17310 Wright St Ste 103
Omaha NE 68130-2405
Phone: (833) 228-6889
Fax: (877) 853-0376
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 34173 | Arizona |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 2018011357 | Missouri |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 11738C | Wyoming |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MTL-2023-030 | Guam |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 16510 | North Dakota |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | M-2422 | Guam |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 34173 | Arizona |
Profile Details
| NPI number | 1003802968 |
|---|---|
| LBN Legal business name | Smith, Stanley R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 26th, 2005 |
| Last updated | Jan 31st, 2024 - about 8 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 | 1003802968 | NPPES |
| Arizona | MEDICAID | 907925 |
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