Individual
STANTON PAUL HEYDINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
764 LAKELAND DR, JACKSON, MS 39216-4651
(601) 984-5020
Mailing address
118 COPPER RIDGE CT, MADISON, MS 39110-6948
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
T-5312
MS
Other
Enumeration date
06/06/2020
Last updated
07/01/2024
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