Stanley R Easterling, MD - Medicare Family Medicine in Vicksburg, MS

Stanley R Easterling, MD is a medicare enrolled "Family Medicine" physician in Vicksburg, Mississippi. His current practice location is 104 Mcauley Dr, Vicksburg, Mississippi. You can reach out to his office (for appointments etc.) via phone at (601) 638-7271.

Stanley R Easterling is licensed to practice in Mississippi (license number 10687) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1154359818.

Contact Information

Stanley R Easterling, MD
104 Mcauley Dr,
Vicksburg, MS 39183-2825
(601) 638-7271
Not Available



Physician's Profile

Full NameStanley R Easterling
GenderMale
SpecialityFamily Medicine
Location104 Mcauley Dr, Vicksburg, Mississippi
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1154359818
  • Provider Enumeration Date: 06/29/2006
  • Last Update Date: 08/19/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 1254464209
  • Enrollment ID: I20100728000749

Medical Identifiers

Medical identifiers for Stanley R Easterling such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1154359818NPI-NPPES
1383872MedicaidLA
00114107MedicaidMS
4216184OtherMSAETNA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 10687 (Mississippi)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Stanley R Easterling allows following entities to bill medicare on his behalf.
Entity NameVicksburg Clinic Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1790711158
PECOS PAC ID: 5890696330
Enrollment ID: O20040116000738

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Entity NamePathway Healthcare- Columbus Ms Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1245755990
PECOS PAC ID: 4385903905
Enrollment ID: O20180104001883

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Entity NamePathway Healthcare- Mississippi Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013425503
PECOS PAC ID: 3779844774
Enrollment ID: O20180308001891

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Entity NamePathway Healthcare - Jackson, Ms, Llc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1487179156
PECOS PAC ID: 1052674439
Enrollment ID: O20180417002749

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stanley R Easterling is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Stanley R Easterling, MD
1000 Urban Center Dr, Ste 600,
Vestavia, AL 35242-2584

Ph: (601) 638-7271
Stanley R Easterling, MD
104 Mcauley Dr,
Vicksburg, MS 39183-2825

Ph: (601) 638-7271

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Family Medicine Doctors in Vicksburg, MS

Dr. Robert C Masterson, DO
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1901 Mission 66, Vicksburg, MS 39180
Phone: 601-636-8244    
Carlos Alberto Latorre, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1901 Mission 66, Vicksburg, MS 39180
Phone: 601-636-0097    
George Abraham, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1907 Mission 66, Vicksburg, MS 39180
Phone: 601-619-3838    
John R Barnes, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1901 Mission 66, Vicksburg, MS 39180
Phone: 601-636-0097    Fax: 601-629-9969
Dr. Robert Michael Cannon, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1901 Mission 66, Vicksburg, MS 39180
Phone: 601-636-0097    Fax: 601-629-9969
Breanna Heard-pinho,
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 1901 Mission 66, Vicksburg, MS 39180
Phone: 601-636-1050    Fax: 601-631-2337

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