Basic Information
Provider Information
NPI: 1740403583
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STANTON
FirstName: RONALD
MiddleName: A
NamePrefix: MR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2055 NORMANDIE DR
Address2: SUITE 108
City: MONTGOMERY
State: AL
PostalCode: 361112732
CountryCode: US
TelephoneNumber: 3342696337
FaxNumber: 3348340657
Practice Location
Address1: 2055 NORMANDIE DR
Address2: SUITE 108
City: MONTGOMERY
State: AL
PostalCode: 361112732
CountryCode: US
TelephoneNumber: 3342884624
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/10/2007
LastUpdateDate: 10/17/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202XMD.29560ALN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0204XMD 29560ALY Allopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology

No ID Information.


Home