MEDICARE: DR. JOHN STOCKING 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
1	174400000X	Specialist	24377	KY
2	207LA0401X	Addiction Medicine (Anesthesiology) Physician	24377	KY

General Provider Information

NPI Number	:	1841280575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN STOCKING M.D.

Provider Business Mailing Address
First Line	:	14800 HEDGEWICK WAY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40245-8498
Country	:	US
Telephone Number	:	502-599-1907
Fax Number	:

Provider Business Practice Location Address
First Line	:	8521 LA GRANGE RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40242-3800
Country	:	US
Telephone Number	:	502-599-1907
Fax Number	:

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	10/29/2020

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Directions to “ DR. JOHN STOCKING M.D.” Practice Location

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