Individual
DR. JASON DEAN STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5700
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5700
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
AU5009697-1584
MS
Other
Enumeration date
06/30/2009
Last updated
02/17/2014
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