Provider Demographics
NPI:1003973082
Name:HURTT, STANLEY DERRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:DERRICK
Last Name:HURTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:1001 S GEORGE ST
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17405-7198
Practice Address - Country:US
Practice Address - Phone:717-851-5001
Practice Address - Fax:717-851-5114
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD430814207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA109291OtherGEISINGER HEALTH PLAN YH
PA212178OtherUNISON-YH
PA7412949OtherAETNA-YH
PA30156216OtherAMERIHEALTH CARITAS - GH
PA1958779OtherHIGHMARK BLUE SHIELD-YH
PA101886329Medicaid
PA20061846OtherAMERIHEALTH MERCY-YH
PA1567921OtherGATEWAY-WMG
PA30124654OtherAMERIHEALTH MERCY - WSRH
PA50068350OtherCAPITAL BLUE CROSS-YH
PA207625OtherJOHNS HOPKINS-YH
PA109291OtherGEISINGER HEALTH PLAN YH
PA50068350OtherCAPITAL BLUE CROSS-YH
PA1567921OtherGATEWAY-WMG