Individual provider · Type 1 NPI

Ian Stack, PA

Medical Physician Assistant · Pinehurst, NC

NPI number 1154590529 Active

Practice location

35 Memorial Dr
Pinehurst, NC 28374-8708

Call (910) 715-7856 Map

Mailing address

126 James Creek Rd
Southern Pines, NC 28387-6819

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X103480 (NC)

Medical Physician Assistant: Definition to come...

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About NPI 1154590529

Ian Stack, PA's National Provider Identifier is 1154590529, issued on Feb 29, 2008. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Pinehurst, NC. The record was last updated on Feb 29, 2008.