Provider Demographics
NPI:1497353247
Name:STANDER NEUROLOGY INC.
Entity Type:Organization
Organization Name:STANDER NEUROLOGY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:STANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:319-333-0593
Mailing Address - Street 1:5740 FLAG WAY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-4434
Mailing Address - Country:US
Mailing Address - Phone:319-333-0593
Mailing Address - Fax:
Practice Address - Street 1:1400 E BOULDER ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5533
Practice Address - Country:US
Practice Address - Phone:719-365-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital