Provider Demographics
NPI:1215556527
Name:STANEK, ERIC JON (DO)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:JON
Last Name:STANEK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4200 UNIVERSITY AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-5945
Mailing Address - Country:US
Mailing Address - Phone:319-431-9776
Mailing Address - Fax:
Practice Address - Street 1:3770 8TH ST SW
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-1048
Practice Address - Country:US
Practice Address - Phone:515-645-9905
Practice Address - Fax:515-967-5581
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IADO-06785207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine