Individual
JAMES K STANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1117 SUNSET DR, SUITE 101, GRENADA, MS 38901-4080
(662) 227-1744
(662) 226-1116
Mailing address
1117 SUNSET DR, SUITE 101, GRENADA, MS 38901-4080
(662) 227-1744
(662) 226-1116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12541
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00125675
—
MS
Enumeration date
08/31/2006
Last updated
07/08/2007
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