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Individual

JAMES KEITH STANFORD II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2200 HIGHWAY 61 N STE 2300, VICKSBURG, MS 39183-8246
(601) 883-3320
(601) 883-3326
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7361
(615) 628-6877

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
T-3219
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01882015
MS
Enumeration date
04/19/2016
Last updated
02/28/2022
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