Doctor Name: | DR. STANLEY WAYNE HIMES |
NPI Number: | 1316047400 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 33839 |
Business Practice Address: | 5656 Veterans Pkwy Columbus, GA - 319049002 |
Business Phone Number: | 7065752106 |
Business Fax Number: | 7065442369 |
Mailing Address: | 578 Pinewood Way, CATAULA |
State: | GA |
Postal Code: | 318044489 |
Phone Number: | 7065752106 |
Fax Number: | 7065441543 |
NPI Enumeration Date: | 09/25/2006 |
NPI Last Update Date: | 06/08/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 33839 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |