Provider Demographics
NPI:1093883753
Name:SHARON STOCKING MD PC
Entity Type:Organization
Organization Name:SHARON STOCKING MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:L
Authorized Official - Last Name:STOCKING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-680-9400
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
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:SUITE 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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD261942085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3106758OtherBC-BS PROVIDER NUMBER
TN3808490Medicaid
TN3808490Medicaid
TN3808490Medicare PIN