# STANFORD MEDICAL INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811201544
- **Authorized official:** DR. JAMES KEITH STANFORD M.D. (OWNER)
- **Authorized official phone:** (662) 227-1744

## Contact information

- **Practice address:** 1117 SUNSET DR, SUITE 101, GRENADA, MS 38901-4080
- **Practice address phone:** (662) 227-1744
- **Practice address fax:** (662) 226-1116
- **Mailing address:** 1117 SUNSET DR, SUITE 101, GRENADA, MS 38901-4080
- **Mailing address phone:** (662) 227-1744
- **Mailing address fax:** (662) 226-1116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/05/2010
- **Last updated:** 11/08/2010