Provider Demographics
NPI:1710528203
Name:STANNARD, TONY J
Entity Type:Individual
Prefix:MR
First Name:TONY
Middle Name:J
Last Name:STANNARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13073 W BUTTER BUSH ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-7268
Mailing Address - Country:US
Mailing Address - Phone:520-271-2783
Mailing Address - Fax:
Practice Address - Street 1:7455 W TWIN PEAKS RD STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-1542
Practice Address - Country:US
Practice Address - Phone:520-638-6253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-05
Last Update Date:2019-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical