# J DEAN STOCKSTILL MD, A PROFESSIONAL MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053626945
- **Authorized official:** DR. JAMES DEAN STOCKSTILL MD (PRESIDENT)
- **Authorized official phone:** (317) 323-7576

## Contact information

- **Practice address:** 3510 MAGNOLIA CV, SUITE 190, MONROE, LA 71203-2372
- **Practice address phone:** (318) 323-7576
- **Practice address fax:** (318) 322-7131
- **Mailing address:** 3510 MAGNOLIA CV, SUITE 190, MONROE, LA 71203-2372
- **Mailing address phone:** (318) 323-7576
- **Mailing address fax:** (318) 322-7131

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | L06937R | LA | Yes |

## Other

- **Enumeration date:** 08/16/2010
- **Last updated:** 08/16/2010