BRENDAN CURRAN STACK JR. MD - NPI 1437165164 - Otolaryngology in Springfield, IL

Q: What is Brendan Stack's NPI number?

The NPI number for Brendan Stack is 1437165164. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Q: What is Brendan Stack's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Plastic Surgery within the Head & Neck, with taxonomy code 207YX0007X.

Q: When was this NPI record last updated?

The NPPES record for Brendan Stack was last updated on February 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

On this page

About Brendan Curran Stack Jr. Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRENDAN CURRAN STACK JR. MD (NPI 1437165164) is an individual plastic surgery within the head & neck provider in Springfield, Illinois, licensed in Illinois (036-151806) and active in the NPI registry since August 2006. He maintains a secondary practice location in Little Rock.

NPPES Registry Identity

NPI1437165164

Entity TypeIndividualMale

Primary Taxonomy207YX0007X

Provider Legal NameBRENDAN CURRAN STACK JR.Credential: MD

Location Address720 N BOND STSpringfield, IL 62702-4952

Mailing Address21001 Lake Vista DrRoland, AR 72135-8017 · (501) 868-7299

Phone(217) 545-8000

Sole ProprietorNo

Enumeration DateAugust 1, 2006

Last NPPES UpdateFebruary 19, 2020

✔ NPI 1437165164 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOtolaryngology · Plastic Surgery within the Head & NeckAllopathic & Osteopathic Physicians

Taxonomy Code207YX0007X

Licenses✔ Licensed in IL · 036-151806✔ Licensed in AR · E-4564

Definition

An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.

Also ListedOtolaryngologyTaxonomy 207Y00000X · License E4564 (AR)

Also ListedOtolaryngology · Facial Plastic SurgeryTaxonomy 207YS0123X · License E4564 (AR)

720 N BOND ST, Springfield, IL 62702

Open in Google Maps ↗

Secondary Practice Location 1

Location 14301 W Markham St # 543Little Rock, AR 72205-7101 · Phone (501) 686-5140 · Fax (501) 526-7153

Other Identifiers 6

Other5N2817666Additional Medicare

OtherE4564AR · Medical License

OtherT2005-275AR · Tricare

Other5N281AR · Bcbs

Other0507002300AR · Qualchoice

Medicaid158045001AR

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NEELAM PRAKASH PHALKE MD

Otolaryngology (Facial Plastic Surgery)