Stackow, John Christopher
Stackow, John Christopher is an individual health care provider with primary practice located at 750 N Syringa St Ste 190 , Post Falls ID 83854-5275. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Stackow, John Christopher can be contacted via phone (208) 262-2328.Contact Information
Primary practice address
750 N Syringa St Ste 190
Post Falls ID 83854-5275
Phone: (208) 262-2328
Fax: (208) 619-5057
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | M-6239 | Idaho |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | M-6239 | Idaho |
Profile Details
| NPI number | 1922095397 |
|---|---|
| LBN Legal business name | Stackow, John Christopher |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 30th, 2005 |
| Last updated | Apr 2nd, 2021 - about 4 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 | 1922095397 | NPPES |
| Washington | MEDICAID | 1022315 | |
| Washington | MEDICAID | 1922095397 |
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