Stack, John M

Stack, John M is an individual health care provider with primary practice located at 735 Fitzwatertown Rd Suite 4, Willow Grove PA 19090-1338. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Stack, John M can be contacted via phone (215) 914-4400.

Contact Information

Primary practice address
735 Fitzwatertown Rd Suite 4 Willow Grove PA 19090-1338
Phone: (215) 914-4400
Fax: (215) 657-4887
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X MD011031E Pennsylvania

Profile Details

NPI number 1831181056
LBN Legal business name Stack, John M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2005
Last updated Dec 2nd, 2015 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831181056 NPPES
Pennsylvania MEDICAID 00725447

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