MEDICARE: LAKELAND ANESTHESIA, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician
2	367500000X	Certified Registered Nurse Anesthetist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CC3482	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053358937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKELAND ANESTHESIA, PLLC

Provider Business Mailing Address
First Line	:	3010 LAKELAND CV
Second Line	:	SUITE J
City	:	FLOWOOD
State	:	MS
Zip	:	39232-9784
Country	:	US
Telephone Number	:	601-936-0681
Fax Number	:	601-936-0686

Provider Business Practice Location Address
First Line	:	1026 N FLOWOOD DR
Second Line	:
City	:	FLOWOOD
State	:	MS
Zip	:	39232-9532
Country	:	US
Telephone Number	:	601-936-0681
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALAN STALLINGS JR.
Credential	:	M.D.
Telephone Number	:	601-936-0681

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	09/11/2025

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