Stocum, Renny Joe
Stocum, Renny Joe is an sole proprietor health care provider with primary practice located at 4000 Coliseum Dr Ste 200A , Hampton VA 23666-5975. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Stocum, Renny Joe can be contacted via phone (757) 736-1520.Contact Information
Primary practice address
4000 Coliseum Dr Ste 200A
Hampton VA 23666-5975
Phone: (757) 736-1520
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 007239 | New York |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 0110007831 | Virginia |
Profile Details
| NPI number | 1700096583 |
|---|---|
| LBN Legal business name | Stocum, Renny Joe |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 23rd, 2007 |
| Last updated | Mar 4th, 2024 - about 8 months 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 | 1700096583 | NPPES |
| New York | MEDICAID | 02499705 |
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