Stanley Kurley Jr., PA-C, ATC
Individual provider Active NPI Physician Assistant · Polacca, AZ
NPI 1891751574 · NPPES record last updated Oct 23, 2013
Key facts
- NPI
- 1891751574
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 5088 (AZ)
- Practice address
- Highway 264 Mile Post 388
Polacca, AZ 86042-4000 - Phone
- (928) 737-6000
- Fax
- (928) 737-6080
- NPI assigned
- Apr 21, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5088 | AZ | MD | Pharmacist |
| 0526 | AZ | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 0526 | AZ | |
| Physician Assistant | 363A00000X | 5088 | AZ | Yes |
Addresses
Primary practice location
Highway 264 Mile Post 388
Polacca, AZ 86042-4000
Mailing address
PO Box 4000
Route 264 Mile Post 388
Polacca, AZ 86042-4000
Phone (928) 737-6000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020529 | Medicaid | AZ |
Other providers in Polacca, AZ
- Andrea Lynn Joshevama
- Carletta J Joshevama
- Zainab Khatoon
- Gina Marie Kosek
- Nancy Kramer
- Erica Lalo
- Han Le
- Anna Klaertje Lewis
- Susan Lippold
- Marti E. Loew
All providers in Polacca, AZ · Physician Assistant in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.