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NPI Code Detail

MEDICARE: LORNA DIANNE STOOKEY M.D.

MEDICARE: LORNA DIANNE STOOKEY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician2005034478MO
2207Q00000XFamily Medicine Physician35-0-78975OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00305304OTHERMOUHC/RAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3201177OTHERMOMO BLUE CROSS

General Provider Information

NPI Number : 1487661666
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORNA DIANNE STOOKEY M.D.
Provider Business Mailing Address
First Line : 611 W MAIN ST
Second Line :
City : FREDERICKTOWN
State : MO
Zip : 63645-1111
Country : US
Telephone Number : 573-783-4111
Fax Number : 573-783-1096
Provider Business Practice Location Address
First Line : 611 W MAIN ST
Second Line :
City : FREDERICKTOWN
State : MO
Zip : 63645-1111
Country : US
Telephone Number : 573-783-4111
Fax Number : 573-783-1096
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2006
Last Update Date : 03/07/2023

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Directions to “ LORNA DIANNE STOOKEY M.D.” Practice Location

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