Provider Demographics
NPI:1972519643
Name:FEATHERSTON, STACY BIUS (PD)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:BIUS
Last Name:FEATHERSTON
Suffix:
Gender:F
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 W BEEBE CAPPS EXPY
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-5018
Mailing Address - Country:US
Mailing Address - Phone:501-268-1120
Mailing Address - Fax:501-268-0326
Practice Address - Street 1:2221 W BEEBE CAPPS EXPY
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-5018
Practice Address - Country:US
Practice Address - Phone:501-268-1120
Practice Address - Fax:501-268-0326
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
AR7399183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR56030100001Medicare ID - Type Unspecified