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General NPI Number Information
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NPI Number | 1366467094
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Entity Type | Individual
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Provider Name | JOHN HENRY STOCK MD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 05/03/2017
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Provider Practice Location Address
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Address Line | 7505 S MCCLINTOCK DR SUITE 103
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City | TEMPE
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State | AZ
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Zip | 85283-5042
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Country | US
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Telephone | 480-755-1000
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Fax | 480-755-0011
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Provider Business Mailing Address
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Address Line | 2222 S DOBSON RD SUITE 305
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City | MESA
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State | AZ
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Zip | 85202-6481
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Country | US
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Telephone | 480-306-8151
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Fax | 480-404-7236
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 25426
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License Number State | AZ
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