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Individual

DR. STACY MATTHEW HOCKETT

Active
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Individual

DR. STACY MATTHEW HOCKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39791
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0114149
MEDICA
MN
01
—
1034895
PREFERRED ONE
MN
01
—
121194
UCARE MN
MN
01
—
1892373
AMERICA'S PPO
MN
01
—
6606626
MEDICA UC
MN
01
—
68F04HO
BCBS OF MN
MN
01
—
7416497
AETNA
MN
05
—
751453100
—
MN
01
—
HP39201
HEALTHPARTNERS
MN
Enumeration date
04/10/2006
Last updated
04/10/2012
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