MEDICARE: NOAH MASON STOCKARD

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	225100000X	Physical Therapist	PTH12608	AL

General Provider Information

NPI Number	:	1134070741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOAH MASON STOCKARD

Provider Business Mailing Address
First Line	:	109 42ND ST S
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35222-1904
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3780 RIVERCHASE VLG STE 900
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-1210
Country	:	US
Telephone Number	:	205-242-9090
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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Directions to “ NOAH MASON STOCKARD ” Practice Location

Language	Start Address	Practice Location

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