MEDICARE: SHARON STOCKING MD PC

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	2085R0202X	Diagnostic Radiology Physician	MD26194	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3106758	OTHER	TN	BC-BS PROVIDER NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093883753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHARON STOCKING MD PC

Provider Business Mailing Address
First Line	:	PO BOX 248
Second Line	:
City	:	HENDERSONVILLE
State	:	TN
Zip	:	37077-0248
Country	:	US
Telephone Number	:	931-680-9400
Fax Number	:	931-680-9835

Provider Business Practice Location Address
First Line	:	310 COLLOREDO BLVD
Second Line	:	SUITE B
City	:	SHELBYVILLE
State	:	TN
Zip	:	37160-2764
Country	:	US
Telephone Number	:	931-680-9400
Fax Number	:	931-680-9835

Authorized Official
Title or Position	:	RADIOLOGIST
Name	:	DR. SHARON L STOCKING
Credential	:	M.D.
Telephone Number	:	931-680-9400

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	12/18/2012

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