Provider Demographics
NPI:1154577799
Name:STANLEY SHARP MD LC
Entity type:Organization
Organization Name:STANLEY SHARP MD LC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:816-777-8888
Mailing Address - Street 1:5209 W 68TH ST
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-1417
Mailing Address - Country:US
Mailing Address - Phone:816-777-8888
Mailing Address - Fax:816-777-1777
Practice Address - Street 1:1310 CARONDELET DR STE 230
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4853
Practice Address - Country:US
Practice Address - Phone:816-777-8888
Practice Address - Fax:816-777-1777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6B11207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty