Provider Demographics
NPI:1982609640
Name:AFFILIATES IN PATHOLOGY SC
Entity Type:Organization
Organization Name:AFFILIATES IN PATHOLOGY SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPREI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-442-9519
Mailing Address - Street 1:100 FOUNTAIN AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-2771
Mailing Address - Country:US
Mailing Address - Phone:270-442-9519
Mailing Address - Fax:314-631-4491
Practice Address - Street 1:1530 LONE OAK RD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-7901
Practice Address - Country:US
Practice Address - Phone:270-442-9519
Practice Address - Fax:314-631-4491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000317622OtherBCBS KY PIN
KYDC1348OtherMEDICARE RAILROAD
KY000000317622OtherBCBS KY PIN