Stanton, Thaddeus Michael
Stanton, Thaddeus Michael is an individual health care provider with primary practice located at 525 Western Ave Suite 203, Conway AR 72034-4967. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Stanton, Thaddeus Michael can be contacted via phone (501) 327-4828.Contact Information
Primary practice address
525 Western Ave Suite 203
Conway AR 72034-4967
Phone: (501) 327-4828
Fax: (501) 327-6899
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | C6890 | Arkansas |
Profile Details
| NPI number | 1053313056 |
|---|---|
| LBN Legal business name | Stanton, Thaddeus Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 10th, 2005 |
| Last updated | Nov 18th, 2009 - about 15 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 | 1053313056 | NPPES |
| Arkansas | Other | 02009881 | MEDICARE RAILROAD |
| Arkansas | Other | 4339027 | MEDICARE RAILROAD |
| Arkansas | MEDICAID | 111393001 | MEDICARE RAILROAD |
| Arkansas | Other | 15289000000 | MEDICARE RAILROAD |
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