Provider Demographics
NPI:1700954377
Name:STOCKER, JOHN THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:THOMAS
Last Name:STOCKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6604 LANDON LN
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-5636
Mailing Address - Country:US
Mailing Address - Phone:301-295-3480
Mailing Address - Fax:301-295-1640
Practice Address - Street 1:4301 JONES BRIDGE ROAD
Practice Address - Street 2:DEPT PATHOLOGY-USUHS
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4799
Practice Address - Country:US
Practice Address - Phone:301-295-3480
Practice Address - Fax:301-295-1640
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17947171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider