Male or Other

Dr. Keith L. Stanley MD

Sports Medicine (Family Medicine) Physician in Tulsa, OK(View on Map)

Full Name

Dr. Keith L Stanley MD

NPI Number

1992773188

NPI Type

Individual Provider

Gender

Male

Enumeration Date

03/14/2006

Specialties

(Taxonomies)

Code

207QS0010X

Primary Taxonomy

Yes

Licenses

State

Oklahoma

License Number

15232

Contact
Information

Purpose

Mailing
Location

Address

4802 S 109TH E AVENUE
4802 S 109TH EAST AVE

City

Tulsa
Tulsa

State

OK
OK

Postal Code

74146
74146-5822

Country

US
US

Telephone Number

(918) 392-1400
(918) 392-1400

Identifiers

Identifier

P00155592

Identifier State

OK

Identifier Issuer

RAILROAD MEDICARE

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 11/01/2007

Provider Address

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