| Doctor Name: | MR. WILLIAM STEPHEN STANLEY |
| NPI Number: | 1053696518 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | R.PH. |
| License Number: | RP00004818 |
| Business Practice Address: | 955 South Second Street Del Norte Pharmacy Raton, NM - 87740 |
| Business Phone Number: | 5754455163 |
| Business Fax Number: | 5754455393 |
| Mailing Address: | Po Box 1841, RATON |
| State: | NM |
| Postal Code: | 87740 |
| Phone Number: | 5209219495 |
| Fax Number: | 5754455393 |
| NPI Enumeration Date: | 10/17/2011 |
| NPI Last Update Date: | 10/17/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1835N1003X |
| License Number: | RP00004818 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacist |
| Taxonomy Specialization: | Nutrition Support |
| Taxonomy Definition: | A licensed pharmacist who has demonstrated specialized knowledge and skill in maintenance and/or restoration of optimal nutritional status, designing and modifying treatment according to patient needs. |