Easterling, Stanley R

Easterling, Stanley R is an individual health care provider with primary practice located at 104 Mcauley Dr , Vicksburg MS 39183-2825. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Easterling, Stanley R can be contacted via phone (601) 638-7271.

Contact Information

Primary practice address
104 Mcauley Dr Vicksburg MS 39183-2825
Phone: (601) 638-7271
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 10687 Mississippi

Profile Details

NPI number 1154359818
LBN Legal business name Easterling, Stanley R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Aug 19th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154359818 NPPES
Louisiana MEDICAID 1383872
Louisiana MEDICAID 00114107
Louisiana Other 4216184

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