Doctor Name: | JOHN L STANTON |
NPI Number: | 1245233063 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD28572 |
Business Practice Address: | 980 Professional Park Dr Suite A Clarksville, TN - 370405251 |
Business Phone Number: | 9319051001 |
Business Fax Number: | 9319050410 |
Mailing Address: | 3024 Business Park Cir, GOODLETTSVILLE |
State: | TN |
Postal Code: | 370723132 |
Phone Number: | 6158516033 |
Fax Number: | 6152969935 |
NPI Enumeration Date: | 05/24/2005 |
NPI Last Update Date: | 04/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD28572 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |