Provider Demographics
NPI:1487861357
Name:STANCIL, STEPHEN PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:PAUL
Last Name:STANCIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1129 HALE RD
Mailing Address - Street 2:MEMPHIS CHILDRENS CLINIC
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116-6373
Mailing Address - Country:US
Mailing Address - Phone:901-396-0390
Mailing Address - Fax:901-396-8151
Practice Address - Street 1:1129 HALE RD
Practice Address - Street 2:MEMPHIS CHILDRENS CLINIC
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-6373
Practice Address - Country:US
Practice Address - Phone:901-396-0390
Practice Address - Fax:901-396-8151
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN43743208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics