Provider Demographics
NPI:1942436407
Name:STOCK, LINDSEY M (PA)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:M
Last Name:STOCK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:LINDSEY
Other - Middle Name:M
Other - Last Name:SADLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:621 S ILLINOIS AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-5489
Mailing Address - Country:US
Mailing Address - Phone:641-494-3000
Mailing Address - Fax:641-494-3059
Practice Address - Street 1:1000 4TH ST SW
Practice Address - Street 2:SUITE ER
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2800
Practice Address - Country:US
Practice Address - Phone:641-422-7234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2017-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002000363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA23473023Medicare Oscar/Certification