Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 55723 | MA |
NPI | 1023152618 |
---|---|
Provider Name | John L Stock |
First Address | Southborough, MA 01772-1102 |
Second Address | Southborough, MA 01772-1102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 08/07/2007 |