Provider Demographics
NPI:1215348859
Name:STANLEY, ARTHUR JORDAN (MD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:JORDAN
Last Name:STANLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JORDAN
Other - Middle Name:
Other - Last Name:STANLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:840 KENNESAW AVE NW STE 7
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7928
Mailing Address - Country:US
Mailing Address - Phone:205-533-0590
Mailing Address - Fax:770-230-2020
Practice Address - Street 1:840 KENNESAW AVE NW STE 7
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7928
Practice Address - Country:US
Practice Address - Phone:770-230-2020
Practice Address - Fax:770-230-2020
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA83395207W00000X, 207WX0009X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA83395OtherGEORGIA COMPOSITE MEDICAL BOARD