Provider Demographics
NPI:1922773878
Name:JOHN L STANTON MD PC
Entity Type:Organization
Organization Name:JOHN L STANTON MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:STANTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-919-3813
Mailing Address - Street 1:130 ALFREDO DR.
Mailing Address - Street 2:BUILDING 3 SUITE F
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042
Mailing Address - Country:US
Mailing Address - Phone:931-919-3813
Mailing Address - Fax:931-218-6932
Practice Address - Street 1:130 ALFREDO DR.
Practice Address - Street 2:BUILDING 3 SUITE F
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042
Practice Address - Country:US
Practice Address - Phone:931-919-3813
Practice Address - Fax:931-218-6932
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHN L STANTON MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty