Individual
DR. KRAIG MICHAEL STASNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
718 HIGHWAY 11 S STE B, PICAYUNE, MS 39466-5310
(601) 799-0707
(601) 799-0700
Mailing address
718 HIGHWAY 11 S STE B, PICAYUNE, MS 39466-5310
(601) 799-0707
(601) 799-0700
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
611
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00880072
—
MS
01
—
753195132
TAX ID
MS
Enumeration date
09/16/2006
Last updated
11/18/2010
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