Provider Demographics
NPI:1821093790
Name:STANLEY, ALFRED WH JR (MD)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:WH
Last Name:STANLEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2022 BROOKWOOD MEDICAL CTR DR
Mailing Address - Street 2:ACC - SUITE 415
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6808
Mailing Address - Country:US
Mailing Address - Phone:205-250-6964
Mailing Address - Fax:205-250-8916
Practice Address - Street 1:2022 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:ACC - SUITE 415
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6808
Practice Address - Country:US
Practice Address - Phone:205-250-6964
Practice Address - Fax:205-250-8916
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5603207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL132830Medicaid
AL051120884OtherBCBS
AL051120885OtherBCBS
AL051120887OtherBCBS
AL132828Medicaid
AL051511938Medicaid
AL132827Medicaid
AL051120886OtherBCBS
AL132829Medicaid
MS04151851Medicaid
ALC78714OtherVIVA
AL102I066817Medicare PIN
ALC78714OtherVIVA
AL132827Medicaid