Provider Demographics
NPI:1518955889
Name:STOCKHAMMER, STANLEY FRANCIS JR (DO)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:FRANCIS
Last Name:STOCKHAMMER
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:30 WINDING CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-6773
Mailing Address - Country:US
Mailing Address - Phone:386-299-4543
Mailing Address - Fax:386-673-3324
Practice Address - Street 1:30 WINDING CREEK WAY
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-6773
Practice Address - Country:US
Practice Address - Phone:386-299-4543
Practice Address - Fax:386-673-3324
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2022-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS3357207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL060646400Medicaid
FL060646400Medicaid
FLE32080Medicare UPIN