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General NPI Number Information
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NPI Number | 1689631392
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Entity Type | Individual
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Provider Name | RICHARD S TOCKMAN MD
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Gender | Male
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 25A JUNE ST
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City | SANFORD
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State | ME
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Zip | 04073-2642
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Country | US
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Telephone | 207-324-8311
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Fax | 207-324-7899
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Provider Business Mailing Address
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Address Line | PO BOX 233
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City | SANFORD
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State | ME
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Zip | 04073-0233
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Country | US
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Telephone | 207-490-7728
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Fax | 207-490-7069
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 009388
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License Number State | ME
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