Provider Demographics
NPI:1033103098
Name:STUTZ, STANLEY JOHN JR
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:JOHN
Last Name:STUTZ
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-1303
Mailing Address - Country:US
Mailing Address - Phone:508-761-4891
Mailing Address - Fax:
Practice Address - Street 1:21 PEACE ST
Practice Address - Street 2:CORPORATE CARE
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02907-1510
Practice Address - Country:US
Practice Address - Phone:401-456-4020
Practice Address - Fax:401-456-4203
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD 4382207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery