Provider Demographics
NPI:1558651166
Name:CROCHET, STACIA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:STACIA
Middle Name:MARIE
Last Name:CROCHET
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1639 CLIFTON RD. 4TH FLOOR BLDG A
Mailing Address - Street 2:DEPT. OF OBSTETRICS AND GYNECOLOGY
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322
Mailing Address - Country:US
Mailing Address - Phone:404-778-3401
Mailing Address - Fax:404-778-3527
Practice Address - Street 1:1639 CLIFTON RD. 4TH FLOOR BLDG A
Practice Address - Street 2:DEPT. OF OBSTETRICS AND GYNECOLOGY
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322
Practice Address - Country:US
Practice Address - Phone:404-778-3401
Practice Address - Fax:404-778-3527
Is Sole Proprietor?:No
Enumeration Date:2011-04-15
Last Update Date:2015-06-18
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Provider Licenses
StateLicense IDTaxonomies
DCMTL001284207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology