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General NPI Number Information
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NPI Number | 1033172739
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Entity Type | Organization
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Legal Business Name | STOCKS SURGICAL CENTER, PLLC
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Dates
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Enumeration Date | 04/11/2006
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Last Update Date | 10/11/2011
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Provider Practice Location Address
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Address Line | 4414 LAKE BOONE TRL SUITE 309
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City | RALEIGH
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State | NC
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Zip | 27607-7513
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Country | US
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Telephone | 919-850-0880
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Fax | 919-872-5407
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Provider Business Mailing Address
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Address Line | 4414 LAKE BOONE TRL SUITE 309
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City | RALEIGH
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State | NC
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Zip | 27607-7513
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Country | US
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Telephone | 919-850-0880
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Fax | 919-872-5407
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Authorized Official
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Title or Position | PRESIDENT
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Name | LEWIS H. STOCKS III
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Credential | M.D., PH.D.
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Telephone | 919-850-0880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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