Basic Information
| Provider Information | |||||||||
| NPI: | 1720030190 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STANNARD | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | PATRICK | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 843966 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641843966 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5738843300 | ||||||||
| FaxNumber: | 5738840943 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 VIRGINIA AVE | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652120001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5738822663 | ||||||||
| FaxNumber: | 5738849063 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2006 | ||||||||
| LastUpdateDate: | 09/12/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 2009024744 | MO | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 19898 | AL | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XX0005X | 2009024744 | MO | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
ID Information
| ID | Type | State | Issuer | Description | G30839 | 01 | AL | VIVA | OTHER | 000036624 | 01 | AL | BLUE CROSS | OTHER | 009932278 | 05 | AL | MEDICAID | 051528934 | 01 | AL | BLUE CROSS | OTHER | 990006333 | 01 | AL | RAILROAD MEDICARE | OTHER | 000036624 | 05 | AL | MEDICAID |