Paul T Stockmann, MD | |
11123 Parkview Plaza Dr Ste 200, Fort Wayne, IN 46845-1707 | |
(260) 425-6100 | |
(260) 425-6105 |
Full Name | Paul T Stockmann |
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Gender | Male |
Speciality | Surgery - Pediatric Surgery |
Location | 11123 Parkview Plaza Dr Ste 200, Fort Wayne, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588664932 | NPI | - | NPPES |
3289600 | Medicaid | MI | |
PS057466 | Other | CHAMPUS-CHAMPUS | |
329955410 | Medicaid | MI | |
4115660 | Medicaid | MI | |
020H277290 | Other | MI | BLUE CROSS BLUE SHIELD MI |
PS057466 | Other | COMMERCIAL-COMMERCIAL NUMBER | |
1396817714 | Other | MI | GROUP NPI |
700H262310 | Other | BLUE CROSS-BLUE CROSS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2086S0120X | Surgery - Pediatric Surgery | 057466 (Michigan) | Secondary |
2086S0120X | Surgery - Pediatric Surgery | 01078636A (Indiana) | Primary |
Entity Name | Obstetrics And Pediatrics Subspecialty Group Of Kansas And Missouri Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225051618 PECOS PAC ID: 7214009851 Enrollment ID: O20080626000487 |
Mailing Address | Practice Location Address |
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Paul T Stockmann, MD Childrens Hospital Of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201 Ph: (313) 831-3220 | Paul T Stockmann, MD 11123 Parkview Plaza Dr Ste 200, Fort Wayne, IN 46845-1707 Ph: (260) 425-6100 |
Dr. Barton Wade Williams, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 11108 Parkview Circle Dr Ste 5100, Fort Wayne, IN 46845 Phone: 260-266-2800 Fax: 260-266-2805 | |
Dr. Ian H. Cook, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 2121 Lake Ave, Veterans Affairs Medical Center, Fort Wayne, IN 46805 Phone: 260-426-5431 | |
Dr. Patricia L Clark, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 11050 Parkview Circle Dr, Fort Wayne, IN 46845 Phone: 833-724-8326 Fax: 260-425-6845 | |
Dr. Paul Mitchell Bauer, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: Lutheran Hospital, 7950 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-435-7001 | |
Lindsay B Hardley, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 11050 Parkview Circle Dr, Fort Wayne, IN 46845 Phone: 833-724-8326 Fax: 260-425-6845 | |
Kingsley Saahene Okai, MD Surgery Medicare: Medicare Enrolled Practice Location: 7910 W Jefferson Blvd Ste 112, Fort Wayne, IN 46804 Phone: 260-969-7121 Fax: 260-479-4614 | |
Dr. Keith David Clancy, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804 Phone: 260-458-3610 Fax: 260-458-3611 |