Medical school: UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduated: 1989
NPI: 1033220512
Practice Locations (2)
1117 SUNSET DR, SUITE 101
GRENADA, MS 389014080
STANFORD MEDICAL INC
1117 SUNSET DR, SUITE 101
GRENADA, MS 389014080
6622271744
Source: CMS National Downloadable File, September 2026.