Provider Demographics
NPI:1558476465
Name:STANLEY, LOWELL DEAN JR (MD)
Entity Type:Individual
Prefix:MR
First Name:LOWELL
Middle Name:DEAN
Last Name:STANLEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88005 OVERSEAS HWY
Mailing Address - Street 2:SUITE #9/324
Mailing Address - City:ISLAMORADA
Mailing Address - State:FL
Mailing Address - Zip Code:33036-3067
Mailing Address - Country:US
Mailing Address - Phone:345-939-1647
Mailing Address - Fax:
Practice Address - Street 1:88005 OVERSEAS HWY
Practice Address - Street 2:SUITE #9/324
Practice Address - City:ISLAMORADA
Practice Address - State:FL
Practice Address - Zip Code:33036-3067
Practice Address - Country:US
Practice Address - Phone:345-939-1647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000018992207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3033683Medicaid
TN3033683Medicaid
TN3033683Medicare ID - Type Unspecified