Stanley, Keith L

Stanley, Keith L is an individual health care provider with primary practice located at 4802 S 109Th East Ave , Tulsa OK 74146-5822. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Stanley, Keith L can be contacted via phone (918) 392-1400.

Contact Information

Primary practice address
4802 S 109Th East Ave Tulsa OK 74146-5822
Fax: (918) 392-1488
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 15232 Oklahoma

Profile Details

NPI number 1992773188
LBN Legal business name Stanley, Keith L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Nov 1st, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992773188 NPPES
Oklahoma Other P00155592 RAILROAD MEDICARE

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