Provider Demographics
NPI:1518687904
Name:STANLEY, DANNY JOE II (PHARMD)
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:JOE
Last Name:STANLEY
Suffix:II
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:JOEY
Other - Middle Name:
Other - Last Name:STANLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:751 LEADVALE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PINE
Mailing Address - State:TN
Mailing Address - Zip Code:37890-4616
Mailing Address - Country:US
Mailing Address - Phone:606-939-2638
Mailing Address - Fax:
Practice Address - Street 1:102 E BROADWAY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-2323
Practice Address - Country:US
Practice Address - Phone:423-623-0364
Practice Address - Fax:423-623-7294
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46703183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN46703OtherPHARMACIST STATE LICENSE