Provider Demographics
NPI:1891702205
Name:STANCIL, VICKI LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:VICKI
Middle Name:LEE
Last Name:STANCIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 HOGAN LN
Mailing Address - Street 2:SUITE #121
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-8287
Mailing Address - Country:US
Mailing Address - Phone:501-327-3344
Mailing Address - Fax:501-327-2998
Practice Address - Street 1:1475 HOGAN LN
Practice Address - Street 2:SUITE #121
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-8287
Practice Address - Country:US
Practice Address - Phone:501-327-3344
Practice Address - Fax:501-327-2998
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC6670207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine