Individual
STEPHANIE WARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 HOSPITAL DR, TYLERTOWN, MS 39667-2020
(601) 876-5303
(601) 876-0653
Mailing address
200 HOSPITAL DR, TYLERTOWN, MS 39667-2020
(601) 876-5303
(601) 876-0653
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
10709
MS
207R00000X
Internal Medicine Physician
11330
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06706285
—
MS
Enumeration date
09/12/2006
Last updated
06/13/2012
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