Individual
RANDALL J STOCKHAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
3838 S 700 E, STE 200, SALT LAKE CITY, UT 84106-1466
(801) 261-4988
(801) 269-9427
Mailing address
PO BOX 27688, SALT LAKE CITY, UT 84127-0688
(801) 534-1360
(801) 366-9883
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
166962-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06846
—
UT
Enumeration date
07/13/2005
Last updated
07/08/2007
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