Individual
LORNA DIANNE STOOKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
611 W MAIN ST, FREDERICKTOWN, MO 63645-1111
(573) 783-4111
(573) 783-1096
Mailing address
611 W MAIN ST, FREDERICKTOWN, MO 63645-1111
(573) 783-4111
(573) 783-1096
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2005034478
MO
207Q00000X
Family Medicine Physician
35-0-78975
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200037109
—
MO
01
—
201177
MO BLUE CROSS
MO
01
—
P00305304
UHC/RAILROAD MEDICARE
MO
Enumeration date
08/01/2006
Last updated
03/07/2023
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