Hockett, Stacy Matthew
Hockett, Stacy Matthew is an individual health care provider with primary practice located at 10000 Zane Ave N , Brooklyn Park MN 55443-1400. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Hockett, Stacy Matthew can be contacted via phone (763) 572-5710.Contact Information
Primary practice address
10000 Zane Ave N
Brooklyn Park MN 55443-1400
Phone: (763) 572-5710
Fax: (763) 569-6200
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 39791 | Minnesota |
Profile Details
NPI number | 1831152842 |
---|---|
LBN Legal business name | Hockett, Stacy Matthew |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 10th, 2006 |
Last updated | Apr 10th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1831152842 | NPPES |
Minnesota | MEDICAID | 751453100 | |
Minnesota | Other | HP39201 | |
Minnesota | Other | 1034895 | |
Minnesota | Other | 68F04HO | |
Minnesota | Other | 1892373 | |
Minnesota | Other | 6606626 | |
Minnesota | Other | 7416497 | |
Minnesota | Other | 0114149 | |
Minnesota | Other | 121194 |
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