J Dean Stockstill Md, A Professional Medical Corporation | |
3510 Magnolia Cv Suite 190 Monroe LA 71203-2372 | |
(318) 323-7576 | |
(318) 322-7131 |
Full Name | J Dean Stockstill Md, A Professional Medical Corporation |
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Speciality | Family Medicine |
Location | 3510 Magnolia Cv, Monroe, Louisiana |
Authorized Official Name and Position | James Dean Stockstill (PRESIDENT) |
Authorized Official Contact | 3173237576 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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J Dean Stockstill Md, A Professional Medical Corporation 3510 Magnolia Cv Suite 190 Monroe LA 71203-2372 Ph: (318) 323-7576 | J Dean Stockstill Md, A Professional Medical Corporation 3510 Magnolia Cv Suite 190 Monroe LA 71203-2372 Ph: (318) 323-7576 |
NPI Number | 1053626945 |
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Provider Enumeration Date | 08/16/2010 |
Last Update Date | 08/16/2010 |
Medicare PECOS PAC ID | 2365576600 |
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Medicare Enrollment ID | O20100823000277 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053626945 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | L06937R (Louisiana) | Primary |
Provider Name | James D Stockstill |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1063494748 PECOS PAC ID: 7416081757 Enrollment ID: I20100823000328 |
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