Provider Demographics
NPI:1720260045
Name:RAY STAPLETON, CRNA P.C.
Entity Type:Organization
Organization Name:RAY STAPLETON, CRNA P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAY
Authorized Official - Middle Name:E
Authorized Official - Last Name:STAPLETON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:478-784-0665
Mailing Address - Street 1:P.O. BOX 26400
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31221
Mailing Address - Country:US
Mailing Address - Phone:478-784-0665
Mailing Address - Fax:478-784-0665
Practice Address - Street 1:5309 WHITEHOUSE PLANTATION RD.
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210
Practice Address - Country:US
Practice Address - Phone:478-784-0665
Practice Address - Fax:478-784-0665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty