STANLEY R EASTERLING (NPI# 1154359818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154359818 |
| Entity Type | Individual |
| Full Name | STANLEY R EASTERLING |
| Credential | MD |
| Practice Address |
104 Mcauley Dr Vicksburg MS 39183-2825 |
| Mailing Address |
1000 Urban Center Dr Ste 600 Vestavia AL 35242-2584 |
| Practice Telephone | 6016387271 |
| Mailing Telephone | 6016387271 |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2020-08-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 10687 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | AETNA | 4216184 | 01 |
| MS | 00114107 | 05 | |
| LA | 1383872 | 05 |
| Street Address |
104 MCAULEY DR |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39183-2825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861458762 | Mohammad A. Ahmed | Psychiatry & Neurology | 104 Mcauley Dr, Vicksburg, MS 39183-2825 | 2006-04-21 |
| 1013337658 | Vicksburg Nephrology LLC | Internal Medicine | 104 Mcauley Dr, Vicksburg, MS 39183-2825 | 2014-04-22 |
| 1508280066 | Stephanie Fay Phelan | Durable Medical Equipment & Medical Supplies | 104 Mcauley Dr, Vicksburg, MS 39183-2825 | 2014-02-04 |
| 1396168290 | Diabetic Shoe Source | Durable Medical Equipment & Medical Supplies | 104 Mcauley Dr, Vicksburg, MS 39183-2825 | 2014-01-28 |
| 1821431990 | Miranda R Mccaskill | Audiologist | 104 Mcauley Dr, Vicksburg, MS 39183-2825 | 2013-04-09 |
| 1619140399 | Vicksburg Allergy and Asthma | Allergy & Immunology | 104 Mcauley Dr, Vicksburg, MS 39183-2825 | 2008-04-02 |
| 1619149440 | Francine F Johnson | Dietitian, Registered | 104 Mcauley Dr, Vicksburg, MS 39183-2825 | 2008-04-01 |
| 1376660290 | Suzanne Channell | Specialist/Technologist | 104 Mcauley Dr, Vicksburg, MS 39183-2825 | 2007-03-24 |
| 1770511420 | William H Wooten | Internal Medicine | 104 Mcauley Dr, Vicksburg, MS 39183-2825 | 2006-06-30 |
| 1194753772 | Fitten L Mcmillin | Family Medicine | 104 Mcauley Dr, Vicksburg, MS 39183-2825 | 2006-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306217823 | Tracy Curtis | Speech-Language Pathologist | 2100 Us 61, Vicksburg, MS 39183 | 2015-10-09 |
| 1649566894 | The Life Balance Clinic, Behavioral Health Service | Social Worker | 1107 B Openwood St., Vicksburg, MS 39183 | 2011-06-27 |
| 1245428788 | Melanie Joan Waldrop | Nurse Anesthetist, Certified Registered | 2100 Hwy 61n, River Region Medical Center, Vicksburg, MS 39183 | 2007-10-10 |
| 1871714477 | Robert Michael Coleman | Dentist | 2356 Grove Street, Vicksburg, MS 39183 | 2007-05-01 |
| 1942363502 | Visions Physical Therapy | Physical Therapist | 110 Holt Collier Dr, Vicksburg, MS 39183 | 2006-12-18 |
| 1023117991 | Janet S Fisher Dmd Pa | Dentist | 1212 Mission 66, Vicksburg, MS 39183 | 2006-09-21 |
| 1407878663 | Annette Bryant | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2006-07-24 |
| 1932168416 | Promise Hospital of Vicksburg Inc | Long Term Care Hospital | 2100 Highway 61 N Fl 6, Vicksburg, MS 39183 | 2006-03-22 |
| 1164945374 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2310 Clay St, Vicksburg, MS 39183 | 2017-07-19 |
| 1255777025 | Joyce Wanjugu Muruthi | Obstetrics & Gynecology | 2100 Highway 61 N, Vicksburg, MS 39183 | 2013-05-20 |
| Find all providers in zip 39183 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831540350 | Evan Fitzgerald | Family Medicine | 13320 North Blvd, Vicksburg, MI 49097-1514 | 2016-06-27 |
| 1861772105 | First Intermed Corporation | Family Medicine | 4204 Clay Street, Vicksburg, MS 39183-0000 | 2011-08-18 |
| 1912933672 | Lara J Teal Clement | Family Medicine | 710 Newitt Vick Dr, Vicksburg, MS 39183-8746 | 2006-06-24 |
| 1184669798 | George Abraham | Family Medicine | 1907 Mission 66, Vicksburg, MS 39180-3711 | 2006-06-18 |
| 1417999301 | Markus B Stanley | Family Medicine | 110 King Arthurs Rdg, Vicksburg, MS 39180-9767 | 2006-06-12 |
| 1386648244 | David J Schriemer | Family Medicine | 13320 N Boulevard St, Vicksburg, MI 49097-1514 | 2005-06-09 |
| 1922633916 | Physician Management Services of Mississippi, LLC | Family Medicine | 1901 Mission 66, Vicksburg, MS 39180-3711 | 2020-03-10 |
| 1417410911 | Cal-med LLC | Family Medicine | 1901 Mission 66, Vicksburg, MS 39180-3711 | 2019-04-11 |
| 1649755208 | Mea Primary Care Plus, LLC | Family Medicine | 4204 Clay St, Vicksburg, MS 39183-3438 | 2018-09-30 |
| 1023419801 | Vicksburg Medical Teams Mht LLC | Family Medicine | 2080 S Frontage Rd, Suite 100, Vicksburg, MS 39180-5328 | 2014-09-11 |
| Find all providers in VICKSBURG | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.