Search › Mississippi › 183500000X
Ethan Stobaugh
NPI 1326686254 · on the registry since 2019
Practice
- Address
- 3926 Goodman Rd W
Horn Lake, MS 38637 - Phone
- (662) 393-7868
- Organisation at this address
- Kroger Limited Partnership I
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-12-10
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi