Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 1697521205 | UT |
N | 208800000X | Urologist | 3895A | WY |
Y | 208800000X | Urologist | 5350 | MT |
NPI | 1033201181 |
---|---|
Provider Name | Dr. Robert E Stockdale |
First Address | Billings, MT 59101 |
Second Address | Billings, MT 59101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0091851 | (05) | MT |
C64236 | (02) |