Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 4153 | NC |
Y | 213EG0000X | General Practice | 4153 | NC |
N | 1223G0001X | General Practice | DN 6511 | FL |
N | 213EG0000X | General Practice | DN 6511 | FL |
NPI | 1003907288 |
---|---|
Provider Name | Dr. Alfred Kenneth Stockin |
First Address | Charlotte, NC 28211 |
Second Address | Charlotte, NC 28211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 08/07/2007 |