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General NPI Number Information
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NPI Number | 1851385678
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Entity Type | Individual
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Provider Name | DAVID STOCKTON NOLL D.O.
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Gender | Male
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 07/01/2009
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Provider Practice Location Address
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Address Line | 59TH ORTHOPEDIC AND REHAB SQUADRON 2200 BERGQUIST DR STE 1
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City | LACKLAND AFB
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State | TX
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Zip | 78236-9908
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Country | US
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Telephone | 210-292-5044
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Fax |
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Provider Business Mailing Address
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Address Line | 59TH ORTHOPEDIC AND REHAB SQUADRON 2200 BERGQUIST DR STE 1
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City | LACKLAND AFB
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State | TX
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Zip | 78236-9908
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Country | US
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Telephone |
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Fax |
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | DO R7D51
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License Number State | MO
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