Provider Demographics
NPI:1760207294
Name:STANTON, WILLIAM DAVID (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DAVID
Last Name:STANTON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6185 GATEWAY DR APT 206
Mailing Address - Street 2:
Mailing Address - City:WHITESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46075-4445
Mailing Address - Country:US
Mailing Address - Phone:317-478-3750
Mailing Address - Fax:
Practice Address - Street 1:6185 GATEWAY DR APT 206
Practice Address - Street 2:
Practice Address - City:WHITESTOWN
Practice Address - State:IN
Practice Address - Zip Code:46075-4445
Practice Address - Country:US
Practice Address - Phone:317-478-3750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-19
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider