Provider Demographics
NPI:1942313507
Name:STOCKER, CHAD (DO)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:STOCKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:7147 VISTA DR STE 150
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-9317
Mailing Address - Country:US
Mailing Address - Phone:515-875-9925
Mailing Address - Fax:515-875-9923
Practice Address - Street 1:1410 SW TRADITION DR STE 150
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-9188
Practice Address - Country:US
Practice Address - Phone:515-875-9980
Practice Address - Fax:515-875-9981
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA3749207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1942313507Medicaid
IA70154OtherWELLMARK BLUE SHIELD
IA70154OtherWELLMARK BLUE SHIELD