MEDICARE: DR. LEAH GLEAVES STOCKTON M.D.

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	2086X0206X	Surgical Oncology Physician	M-15789	ID

General Provider Information

NPI Number	:	1477813780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEAH GLEAVES STOCKTON M.D.

Provider Business Mailing Address
First Line	:	1072 N LIBERTY ST
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83704-8706
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1072 N LIBERTY ST
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83704-8706
Country	:	US
Telephone Number	:	208-302-3200
Fax Number	:

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

Provider Enumeration Date	:	05/21/2012
Last Update Date	:	12/23/2025

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