Provider Demographics
NPI:1457575367
Name:CURRAN, STACEY M (DO)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:M
Last Name:CURRAN
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 1:116 WOODY DR
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-5692
Mailing Address - Country:US
Mailing Address - Phone:724-287-8500
Mailing Address - Fax:724-287-4128
Practice Address - Street 1:116 WOODY DR
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-5692
Practice Address - Country:US
Practice Address - Phone:724-287-8500
Practice Address - Fax:724-287-4128
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013324207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
129783Medicare PIN