Provider Demographics
NPI:1760585210
Name:STANLEY E HANDSHY, MD
Entity Type:Organization
Organization Name:STANLEY E HANDSHY, MD
Other - Org Name:HANDSHY MEDICAL CLINIC, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:E
Authorized Official - Last Name:HANDSHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:620-244-3291
Mailing Address - Street 1:324 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:KS
Mailing Address - Zip Code:66733-1439
Mailing Address - Country:US
Mailing Address - Phone:620-244-3291
Mailing Address - Fax:620-244-5458
Practice Address - Street 1:324 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:KS
Practice Address - Zip Code:66733-1439
Practice Address - Country:US
Practice Address - Phone:620-244-3291
Practice Address - Fax:620-244-5458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-18856170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical GeneticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200259890BMedicaid
KS178977Medicare Oscar/Certification
KS200259890BMedicaid