Stanford Medical INC

NPI #1811201544 in Grenada, Mississippi

Provider Information

NPI Number: 1811201544
Entity Type: Organization
Organization Name: Stanford Medical INC
Primary Specialty: Family Medicine
Enumeration Date: Aug 5, 2010
Last Updated: Nov 8, 2010

Practice Location

Address: 1117 SUNSET DR
Address 2: SUITE 101
City: Grenada
State: Mississippi
ZIP Code: 38901-4080
Phone: (662) 227-1744

Authorized Official

Name: DR. JAMES KEITH STANFORD, M.D.
Title: OWNER
Phone: (662) 227-1744

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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