Healthcare Provider Details

I. General information

NPI: 1053373233
Provider Name (Legal Business Name): TONI C STOCKTON MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 03/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16611 S. 40 STREET SUITE 100
PHOENIX AZ
85048
US

IV. Provider business mailing address

16611 S. 40 STREET SUITE 100
PHOENIX AZ
85048
US

V. Phone/Fax

Practice location:
  • Phone: 480-610-6366
  • Fax: 480-833-1653
Mailing address:
  • Phone: 480-610-6366
  • Fax: 480-833-1653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number22013
License Number StateAZ

VIII. Authorized Official

Name: DR. TONI CYD STOCKTON
Title or Position: CEO
Credential: M.D.
Phone: 480-610-6366