Provider Demographics
NPI:1063493864
Name:STOCKING, SHARON L (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:L
Last Name:STOCKING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:SHARON L STOCKING MD
Mailing Address - City:HENDERSON
Mailing Address - State:TN
Mailing Address - Zip Code:37077-0248
Mailing Address - Country:US
Mailing Address - Phone:931-680-9400
Mailing Address - Fax:931-680-9835
Practice Address - Street 1:310 COLLOREDO BLVD
Practice Address - Street 2:STE B
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-2764
Practice Address - Country:US
Practice Address - Phone:931-680-9400
Practice Address - Fax:931-680-9835
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD261942085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3808490Medicaid
TN3106758OtherBC
TN3808490Medicare PIN
TN3808490Medicaid