Individual
JOHN STANBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2600 5TH ST N, COLUMBUS, MS 39705-2010
(662) 244-2960
(662) 244-2964
Mailing address
350 N HUMPHREYS BLVD, MEMPHIS, TN 38120-2177
(901) 226-4003
(901) 227-8591
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13912
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00112134
—
MS
Enumeration date
04/26/2006
Last updated
05/14/2025
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