Brendan Curran Stack JR.
Otolaryngologist (ENT Doctor) Facial Plastic Surgeon Plastic Surgeon (Head & Neck)
720 N Bond St
Springfield
, Illinois 62702-4952
Brendan Curran Stack JR.
Otolaryngologist (ENT Doctor) Facial Plastic Surgeon Plastic Surgeon (Head & Neck)
720 N Bond St
Springfield
, Illinois 62702-4952
(501) 868-7299
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About
Features
Specialties
- Otolaryngologist (ENT Doctor)
- Facial Plastic Surgeon
- Plastic Surgeon (Head & Neck)
Languages spoken
- English
Location
First Address
- Brendan Curran Stack JR.
- 21001 Lake Vista Dr
- Roland, AR
- Zip : 72135-8017
- Phone : (501) 868-7299
Second Address
- Brendan Curran Stack JR.
- 720 N Bond St
- Springfield, IL
- Zip : 62702-4952
- Phone : (217) 545-8000
Reviews
FAQs
Where did Brendan Curran Stack JR. attend graduate school?
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What type of doctor is Brendan Curran Stack JR.
In what state does Brendan Curran Stack JR. practice in?
Where is Brendan Curran Stack JR.’s practice located?
What is Brendan Curran Stack JR.’s gender?
Is Brendan Curran Stack JR. a sole practitioner?
Is Brendan Curran Stack JR. accepting new patients?
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Does Brendan Curran Stack JR. offers telemedicine?
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Does Brendan Curran Stack JR. have any license restrictions?
Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207Y00000X | Otolaryngologist (ENT Doctor) | E4564 | AR |
| N | 207YS0123X | Facial Plastic Surgeon | E4564 | AR |
| Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 036-151806 | IL |
| N | 207YX0007X | Plastic Surgeon (Head & Neck) | E-4564 | AR |
National Provider Identifier
| NPI | 1437165164 |
|---|---|
| Provider Name | Brendan Curran Stack JR. |
| First Address | Roland, AR 72135-8017 |
| Second Address | Springfield, IL 62702-4952 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/08/2006 |
| Last Update Date | 19/02/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0507002300 | QUALCHOICE (01) | AR |
| 158045001 | (05) | AR |
| 5N281 | BCBS (01) | AR |
| 5N2817666 | ADDITIONAL MEDICARE (01) | |
| E4564 | MEDICAL LICENSE (01) | AR |
| G19746 | (02) | AR |
| T2005-275 | TRICARE (01) | AR |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.