Organization
WEST MISSISSIPPI MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STANLEY R EASTERLING MD (OWNER)
(601) 636-8184
Entity
Organization
Contact information
Practice address
100 MCAULEY DR, VICKSBURG, MS 39183-2825
(601) 883-3532
Mailing address
607 TIFFINTOWN RD, VICKSBURG, MS 39183-1503
(601) 636-8184
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
10687
MS
Other
Enumeration date
07/27/2017
Last updated
07/27/2017
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