Individual
STANLEY R EASTERLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
104 MCAULEY DR, VICKSBURG, MS 39183-2825
(601) 638-7271
Mailing address
1000 URBAN CENTER DR, STE 600, VESTAVIA, AL 35242-2584
(601) 638-7271
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10687
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114107
—
MS
05
—
1383872
—
LA
01
—
4216184
AETNA
MS
Enumeration date
06/29/2006
Last updated
08/19/2020
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