# ERIC STOCKALL, MD, PLLC

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

## Provider details

- **NPI number:** 1922106103
- **Authorized official:** ERIC ROBERT STOCKALL M.D. (OWNER/MEMBER)
- **Authorized official phone:** (517) 349-3900

## Contact information

- **Practice address:** 2090 JOLLY RD, SUITE 150, OKEMOS, MI 48864-3996
- **Practice address phone:** (517) 349-3900
- **Mailing address:** PO BOX 1070, OKEMOS, MI 48805-1070
- **Mailing address phone:** (517) 349-3900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 4301050188 | MI | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 10/30/2007