Individual
DOUGLAS J STOCKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 W THOMAS RD STE 230, PHOENIX, AZ 85013
(602) 406-9999
(602) 406-8099
Mailing address
3030 N CENTRAL AVE STE 1001, PHOENIX, AZ 85012-2716
(602) 406-4786
(913) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G5653
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076126
VALUE OPTIONS
TX
05
—
114122
—
AZ
05
—
137426604
—
TX
01
—
260041159
RAILROAD MEDICARE
TX
01
—
85500X
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/15/2006
Last updated
07/16/2019
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