Individual
DR. ANZA MAISHA STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-5300
(601) 978-3549
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-5300
(601) 978-3549
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
23265
MS
208000000X
Pediatrics Physician
T-2491
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00233368
—
MS
Enumeration date
07/01/2011
Last updated
05/09/2017
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