Individual
DR. THOMAS G STACKHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 BOWMAN DR, SUITE E-100, VOORHEES, NJ 08043-9623
(609) 267-9400
(609) 267-9457
Mailing address
4 EVES DR # A, SUITE 100, MARLTON, NJ 08053-3195
(609) 267-9400
(609) 267-9457
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MA46176
NJ
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
MA46176
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0065218
GHI
NJ
01
—
0090628000
KEYSTONE
NJ
01
—
1243672
UNITED HEALTHCARE
NJ
01
—
157012
GREAT WEST
NJ
01
—
2K1291
HEALTHNET
NJ
01
—
3730395B
CIGNA
NJ
01
—
4090523
AETNA
NJ
01
—
6569F02206
1ST OPTION
NJ
01
—
BNS012
OXFORD
NJ
Enumeration date
10/04/2006
Last updated
02/23/2015
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