Stanback, John
Stanback, John is an individual health care provider with primary practice located at 4508 Highway 45 N , Columbus MS 39705-2917. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Stanback, John can be contacted via phone (662) 328-9702.Contact Information
Primary practice address
4508 Highway 45 N
Columbus MS 39705-2917
Phone: (662) 328-9702
Fax: (662) 328-0954
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 13912 | Mississippi |
Profile Details
| NPI number | 1629034764 |
|---|---|
| LBN Legal business name | Stanback, John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2006 |
| Last updated | Feb 26th, 2011 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629034764 | NPPES |
| Mississippi | MEDICAID | 00112134 |
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