Provider Demographics
NPI:1407268204
Name:WILLIAM C STANBERY II, MD
Entity Type:Organization
Organization Name:WILLIAM C STANBERY II, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:STANBERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-479-8981
Mailing Address - Street 1:424 BERYWOOD TRL NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-5251
Mailing Address - Country:US
Mailing Address - Phone:423-479-8981
Mailing Address - Fax:423-472-5792
Practice Address - Street 1:424 BERYWOOD TRL NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-5251
Practice Address - Country:US
Practice Address - Phone:423-479-8981
Practice Address - Fax:423-472-5792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty