Provider Demographics
NPI:1306988415
Name:STANLEY NEIL BRAND
Entity type:Organization
Organization Name:STANLEY NEIL BRAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:BRAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-361-6777
Mailing Address - Street 1:6724 TROOST AVE STE 615
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1501
Mailing Address - Country:US
Mailing Address - Phone:816-361-6777
Mailing Address - Fax:816-361-5396
Practice Address - Street 1:6724 TROOST AVE STE 615
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1501
Practice Address - Country:US
Practice Address - Phone:816-361-6777
Practice Address - Fax:816-361-5396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMDR6677174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C51101Medicare UPIN
MO0003537Medicare ID - Type Unspecified