Provider Demographics
NPI:1689610461
Name:STOCKWELL, MARGARET KATHLEEN (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:KATHLEEN
Last Name:STOCKWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 SADDLE DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-5632
Mailing Address - Country:US
Mailing Address - Phone:406-442-0120
Mailing Address - Fax:406-442-0040
Practice Address - Street 1:405 SADDLE DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-5632
Practice Address - Country:US
Practice Address - Phone:406-442-0120
Practice Address - Fax:406-442-0040
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT11153207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTE57564Medicare UPIN
MT149174Medicare ID - Type Unspecified