Provider Demographics
NPI:1669544243
Name:STOCKTON, MELISSA K (DOM)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:K
Last Name:STOCKTON
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6208 MONTGOMERY BLVD NE
Mailing Address - Street 2:SUITE F
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-1400
Mailing Address - Country:US
Mailing Address - Phone:505-888-6208
Mailing Address - Fax:505-888-3011
Practice Address - Street 1:6208 MONTGOMERY BLVD NE
Practice Address - Street 2:SUITE F
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1400
Practice Address - Country:US
Practice Address - Phone:505-888-6208
Practice Address - Fax:505-888-3011
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM593171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist