| Dr Derec Stanislav, DO | |
| 
					201 Nw Rd Mize Road, Blue Springs, MO 64014  | |
| (816) 655-5426 | |
| (816) 655-5408 | 
| Full Name | Dr Derec Stanislav | 
|---|---|
| Gender | Male | 
| Speciality | Orthopaedic Surgery | 
| Location | 201 Nw Rd Mize Road, Blue Springs, Missouri | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1295220689 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | 2018021972 (Missouri) | Primary | 
| Entity Name | Elite Orthopaedics Of Irving Pllc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1982892105 PECOS PAC ID: 3779667092 Enrollment ID: O20080226000350  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Derec Stanislav, DO 201 Nw Rd Mize Road, Blue Springs, MO 64014 Ph: (816) 655-5426  | Dr Derec Stanislav, DO 201 Nw Rd Mize Road, Blue Springs, MO 64014 Ph: (816) 655-5426  | 
Dr. Elijah G Miller, D.O. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 201 Nw Rd Mize Road, Blue Springs, MO 64014 Phone: 816-655-5426 Fax: 816-655-5408  | |
Kevin Andrew Witte, D.O. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 203 Nw R.d. Mize Rd, Ste 250, Blue Springs, MO 64014 Phone: 816-220-8727 Fax: 816-220-8269  | |
Dr. Matthew Thomas Cullen, D.O. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 201 Nw R D Mize Rd, Blue Springs, MO 64014 Phone: 816-655-5426  |