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General NPI Number Information
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NPI Number | 1013013002
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Entity Type | Organization
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Legal Business Name | STOCKDALE PODIATRY GROUP INC
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 110 NEW STINE RD
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City | BAKERSFIELD
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State | CA
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Zip | 93309-2605
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Country | US
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Telephone | 661-832-1666
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Fax | 661-832-2039
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Provider Business Mailing Address
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Address Line | 110 NEW STINE RD
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City | BAKERSFIELD
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State | CA
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Zip | 93309-2605
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Country | US
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Telephone | 661-832-1666
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Fax | 661-832-2039
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | BRANDON HAWKINS
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Credential | DPM
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Telephone | 661-832-1666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State | CA
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