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1770515959

NPI Code Detail

MEDICARE: BENJAMIN R STOCKTON MD

MEDICARE: BENJAMIN R STOCKTON MD

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
1	208800000X	Urology Physician	MD427930	PA
2	208800000X	Urology Physician	4301089581	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00888237	OTHER		RR MEDICARE#

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770515959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN R STOCKTON MD

Provider Business Mailing Address
First Line	:	10200 GRAND CENTRAL AVE STE 220
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-4366
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2530 E SOUTHERN AVE
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85204-5411
Country	:	US
Telephone Number	:	480-834-4188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	03/21/2025

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Directions to “ BENJAMIN R STOCKTON MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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