Provider Demographics
NPI:1821735879
Name:STANLEY, SYDNEY N (DO)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:N
Last Name:STANLEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 PARK DR
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-0553
Mailing Address - Country:US
Mailing Address - Phone:605-484-2627
Mailing Address - Fax:
Practice Address - Street 1:10238 E HAMPTON AVE STE 506
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-3321
Practice Address - Country:US
Practice Address - Phone:480-834-7546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program